Strategic Palliative Design: Enhancing Healthcare for Better QoL

This report discusses the strategic approach to palliative care design in healthcare facilities, emphasizing the improvement of quality of life and reduction of suffering for patients, families, and caregivers. It highlights the consultation services model as a widely used palliative care delivery method, incorporating palliative care specialists, chaplains, social workers, and therapists. The report presents three palliative care designs addressing acute pain syndrome, paralysis, and terminal lung cancer, respectively, each utilizing patient-centered plans, pharmacological interventions, psychotherapy, and environmental adjustments to enhance patient comfort and well-being. The designs also focus on involving clinical psychologists, physiotherapists, and oncologists to promote self-care, motivation, and collaborative decision-making, all based on evidence-based practices.

Palliative care design

 Consultation services is the most reliable and widely used palliative care delivery model, worldwide. Inpatient Progressive
Care units required very intensive management and a collaborative care is very pertinent. Consultation services
incorporates a palliative care specialist physician who is extensively trained in palliative services, in a team of other
palliative care trained chaplains, social workers, volunteers, psychologists, therapists (Wysham et al. 2016). This palliative
care delivery model uses standardized management protocols and assessment tools. Development and definition of
consultant relationship; identification of risks and outcomes, quality control and data analytics are vital aspect of this type
of palliative care.
 In design 1 – Consultation services palliative care delivery model will be used in this design. The patient in
this design suffers from acute pain syndrome and is depressed. Firstly, the wishes and preferences of the
patient will be first noted and a palliative patient centered plan will be formulated accordingly. A
pharmacological intervention to reduce pain and promote sleep will be done. Psychotherapy will be applied
to calm down his fears and anxiety levels. The patient will be communicated by a human becoming nurse
who will make him align with higher existences of universe.
Palliative care design 1

 A Casarett et al. (2008), focused on consultation services palliative care model and revealed that this
specific model had a significant beneficial impact on the families’ perception of hospital care received by
their loved one. This model provides very higher scores on information, on communication, psycho-
emotional support and collaborates the clinical teams with great ease.
 In palliative design 2 – the patient in this design is paralyzed. The patient will be advised to face the
windows that opens to the outside nature which has been seen as an effective measure in many EOL studies
(Sahlin et al. 2016). This care design also uses consultation services model - a palliative care trained
psychologist along with a trained physiotherapist will be intervening this patient throughout the length of
treatment. Ambience of the patient’s room will be changed to a light color to calm down this patient’s
nerves and blood pressure. Sedatives will be given when required very much but normal sleeping patterns
with practice of muscle relaxation techniques, progressive muscle relaxation exercises and breathing
exercises – will be an integral part of patient’s reduced perception to pain.
Palliative care design 2

 The consultation servicing model is concerned with these critical six areas - facility design, management,
operation and attentional parameters to the patient and his family must be assessed for enhancing QoL. To design
a palliative, the clinician’s team must be in a complete ‘harmony’ with the patient’s interests and wishes. These
should be then applied with an effective environmental design.
 In palliative design 3 – the patient in this design is suffering from terminal stage of lung cancer. A physical
therapist with a trained oncologist’s role in important to promote basic ADL self care in the patient. The
consultation servicing model will also incorporate a clinical psychologist to keep him motivated towards life.
Light brown architectures will be put up in the patient’s room as per his preference.. Soft night lamps and proper
ventilation with fresh air will be promoted as they have been seen to cut down anxiety levels (Hope et al. 2018).
A patient centered therapeutic conversation with collaborative decision making will used to decide whether to
provide high doses of chemotherapy or not. The patient will be given all the rights to decide for himself. This
design planning is completely based on Evidence based practice model of healthcare.
Palliative care design 3

Casarett D, Pickard A, Bailey FA, et al. Do palliative care consultations improve outcomes? J Am Geriatr Soc
2008;56:593-599.
Hope, J., Recio‐Saucedo, A., Fogg, C., Griffiths, P., Smith, G.B., Westwood, G. and Schmidt, P.E., 2018. A
fundamental conflict of care: Nurses’ accounts of balancing patients' sleep with taking vital sign observations at
night. Journal of clinical nursing, 27(9-10), pp.1860-1871.
Sahlin, E., Lindegård, A., Hadzibajramovic, E., Grahn, P., Vega Matuszczyk, J. and Ahlborg Jr, G., 2016. The
influence of the environment on directed attention, blood pressure and heart rate—An experimental study using a
relaxation intervention. Landscape research, 41(1), pp.7-25.
Wysham, N.G., Hochman, M.J., Wolf, S.P., Cox, C.E. and Kamal, A.H., 2016. Performance of consultative
palliative care model in achieving quality metrics in the ICU. Journal of pain and symptom management, 52(6),
pp.873-877.
References