Achievement in Palliative Care – measuring outcomes in Thailand

220515250 multiprofessional delegates from across Thailand met at Maharaj Nakorn Chiang Mai Hospital last month to attend the conference: ‘Achievement in Palliative Care’.

The Palliative Care Committee of the hospital organized the conference, and the rapid growth of end of life care is a testament to the enthusiasm for palliative care in this country of 65 million people.

It is only 11 years since Maharaj Nakorn Chiang Mai hospital initiated its first policy for palliative care. The policy has required palliative care-trained nurses in each ward, and doctors trained in palliative care for each specialty.

An on-site temple provides spiritual care and support. Social workers and volunteers – including monks and people from other faith denominations – are also trained in palliative care. Palliative care training is included in religious instruction.

The palliative care committee delivers both teaching and direct care, and this has been underpinned by a commitment to research and tools to measure and improve care.

First, the team led on the Thai validation of the Palliative Performance Scale (PPS), which allows classification of patients by function. This classification has informed a local model of palliative care that provides guidelines on patient management according to their PPS score. This has been published in the academic literature (E.g.: Chewaskulyong et al., 2012).

Second the Family Assessment of Treatment at End of Life Care (FATE) was translated into Thai, and the validation is complete.

Third, at the conference this week, data were presented on the Thai Palliative Outcome Scale (POS). POS is used for palliative cancer patients in the hospital, and POS training has been delivered at around 20 provincial hospitals across Thailand…read more

From ehospice