Organising palliative care
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- A three-tier model for palliative care
- Palliative care centres are responsible for care pathways
- A palliative hospital-at-home brings special level care to the patient
- Quality criteria of palliative care guide the organization
A three-tier model for palliative care
Organising palliative care is being changed to a three-tiered model recommended by the Ministry of Social Affairs and Health. The model divides palliative care services into a basic level and specialised levels. The patient is provided the services that meet their needs.
The purpose of the model is to harmonise practices so that everyone can receive equal care regardless of their place of residence.
Most of the palliative care patients need basic level care. About a third of patients need specialised palliative care.
Basic level
On the basic level, palliative care and hospice care is provided when the need for care and support can be predicted and implemented with advance care plan. If necessary, specialised care will be brought to the patient.
Palliative care on the basic level is provided in all social and healthcare units that treat patients in the final stages of life, such as:
- 24-hour service housing units
- home care units
- inpatient wards of community health centres and hospitals.
A – hospice care units at the basic level
Basic level A hospice care units are health care units, such as inpatient wards of community health centres and hospitals, in which hospice care is taken into account in the number of personnel, training and operating environment. The units have developed hospice care along with their other operations.
B – special level
Special level B units are specialised in palliative and hospice care. Palliative care is their primary task and their personnel is specially trained.
Level B units form a network of special level palliative care in the wellbeing services county. The palliative centres coordinate special level care in their county and are responsible for service chains. Special level units provide basic-level consultation support.
In addition to palliative centres, special level units can be:
- regional home hospitals and their support departments
- palliative departments, hospice care departments and hospices
- palliative outpatient clinics
- palliative consultation teams of hospitals
- day hospitals.
C – demanding special level
The palliative centres of university hospitals provide demanding special level palliative care. They are also responsible for research and education in collaboration with universities and other educational institutions.
The palliative centre of an university hospital consists of:
- a palliative care outpatient clinic
- a palliative care consultation team
- a psychosocial support unit
- a palliative department or palliative beds
- a home hospital
- a day hospital
- a hospice or equivalent hospice care department.
Palliative care centres are responsible for care pathways
Implementation of the national care pathway model requires that palliative plans and care pathways are created on a regional level.
They ensure that
- the patient is provided the services that meet their needs
- all basic level units are assigned a special level unit that provides consultation support on palliative care.
The care pathways in wellbeing services counties are coordinated by the counties palliative centres that operate under central hospitals.
The palliative centres of university hospitals coordinate demanding special level care on local government co-management areas.
A palliative hospital-at-home brings special level care to the patient
A palliative hospital-at-home specialises in palliative care and hospice care.
It provides patients with special level palliative care and hospice care:
- at home
- in residential services, such as services for older people and the disabled
- health care units.
Palliative hospitals-at-home provide hospice care at home and support the basic social and health care units with special level expertise.
The palliative hospital-at-home is a part of the hospital services in the region. Its personnel is a multidisciplinary team that also has expertise on the provision of psychosocial, psychological and spiritual support. The palliative hospital-at-home collaborates closely with the palliative support department.
A dense network of hospitals-at-home ensures that skilled care is close to the patient's home, which avoids unnecessary acute admissions to a hospital.
Quality criteria of palliative care guide the organization
The Ministry of Social Affairs and Health’s guidelines on palliative and end-of-life care specify quality criteria for the different services provided in palliative care.
