1. Palliative care is introduced at cancer-type specific key transition points | |
2. Initial hospital-based palliative care consultation (as inpatient or outpatient), addressing: • Review of underlying disease management • Screening for symptom distress • Screening for psychological distress • Review of informal community supports, including local community palliative care • Providing information • Advance care planning discussions • Involvement of family carer, including enquiry of concerns and needs of information | |
3. Regular, prescribed outpatient follow up: • At minimum monthly for at least 2 months • At conclusion of the prescribed intervention, a clinical decision is made between the patient and palliative care physician for individualized follow-up beyond standard ‘dose’. | |
4. Case conference with the general practitioner within 28 days, addressing: • Current and anticipated problems • Recommended management and therapies |