Page 205 - HA Convention 2015

Corporate Scholarship Presentations

CS3.1 Cancer Services 13:15 Room 228

Hospital Authority Corporate Scholarship Experience — Head and Neck Cancer and Plastic Reconstruction:
Chang Gung Memorial Hospital Tai Wan
Fung TTH
Department of Ear Nose and Throat, Pamela Youde Nethersole Eastern Hospital; Faculty of Medicine School of Biomedical
Sciences, The Chinese University of Hong Kong, Hong Kong

This presentation will discuss the speaker’s experience in head and neck cancer and plastic reconstruction training at Chang
Gung Memorial Hospital (CGMH) of Taiwan, and Memorial Sloan Kettering Cancer Center (MSKCC) of USA.

Head and neck cancer patients suffer from highly debilitated symptoms even after operative excision. Reconstruction of the
facial and upper aerodigestive tract defect is important in restoring one’s basic need of oral intake and breathing, as well as
self-image. CGMH is most renowned as the pioneer of free flap reconstruction, while MSKCC is known for its long heritage
in management of cancer. It is hoped that through the precious experiences at these hospital, further improvement in the
management of existing cancer patients could be achieved.

Tuesday, 19 May

CS3.2 Cancer Services 13:15 Room 228

Headed for Excellence Care: Application Experience from Overseas Palliative Care Training HOSPITAL AUTHORITY CONVENTION 2015
Lam JCY
Department of Medicine and Geriatrics/Palliative Care Unit, Caritas Medical Centre, Hong Kong

According to a survey conducted by Hospital Authority in 2012, the overall palliative care service coverage for patients died
from cancer was 68.3%. Hospitals with a higher accessibility to palliative care service got a higher percentage. However,
hospitals which are more distal from palliative care service got a lower percentage. In order to enhance support for end-of-
life patients in non-palliative care units, palliative care consultative service should be provided.

During the palliative care training in National Cheng Kung University Hospital of Taiwan, one of the many valuable learning
experiences was “Hospice Combine Care – 安寧共同照護 ”. Nurses of the palliative care unit received referrals from other
inpatient units of the hospital. They accessed the patients from the referred units to provide holistic palliative care support.
They initiated meeting with the patients and families for further discussion about the prognosis, care plans and provided
psychosocial support accordingly. The nurses also played a role in discussing advance directives. They helped families to
take chance to express their words, in Chinese this is what we called 四道人生（道謝、道愛、道歉、道別）during the last stage
of life of the patients.

From the learnt experiences, local system has been developed to provide outreaching palliative care nursing consultative
service to another hospital in the same cluster. After service provision, it was found that the number of patients receiving
palliative care service was increased by 84.9%. The waiting time to receive palliative care services was shortened by
85.5%. The waiting time to receive inpatient palliative care services was also shortened by 57.0%. The palliative care nurses
also demonstrated their roles in facilitating symptom control. Moreover, they helped the patients and their relatives in
understanding the pros and cons about some life-sustaining treatment. Psychological support and bereavement counselling
were provided to patients and their relatives. Moreover, the palliative care nurses facilitated well-timed multidisciplinary
interventions.

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