Hospital palliative care support teams in France: A nationwide descriptive study

Background. - Hospital palliative care support teams have been widely developed in France since 1987. However, very few studies have been conducted to evaluate and measure this development with more details. Methods. - A retrospective, questionnaire-based survey was conducted among all hospital palliative care support teams in France. The questionnaire aimed to investigate the organization, the composition, the clinical support and the teaching and research activities of the palliative care support teams. Results. - Among 353 hospital palliative care support teams in 2012, 297 (84.1%) participated in the study. Most hospital palliative care support teams are located in public hospitals (87.9%), including 46 in teaching hospitals. Exactly 55.6% of all palliative care support teams have the possibility to intervene both in hospitals and in nursing home facilities. Hospital palliative care support teams have a median annual budget of 289,000 (sic), with an average of 1.1 physician, 1.5 nurse, 0.2 nurse manager, 0.7 psychologist and 0.1 social worker. On average, each palliative care team follows 359 patients (SD = 233). About 92.8% of all interventions occur in hospital facilities and 3.1% in nursing homes. Overall, more than 75% of all interventions from palliative care support teams occur at the patients' bedside, however, less than 25% of these interventions are conducted alongside with the staff member caring for the patients. Finally, hospital palliative care support teams are engaged in both initial education and continuing education initiatives. Conclusion. - Our study shows that in France, hospital palliative care support teams face many challenges with limited resources. Although these transversal services have a great potential for disseminating the palliative care approach in various settings (including nursing homes), our study raises important questions regarding the effectiveness and the sustainability of small and isolated teams. (C) 2015 Elsevier Masson SAS. All rights reserved.