Systems dynamics in the community care pathway at the end-of-life: the Hong Kong experience

Abstract

BACKGROUND: Since 2009, the HKWC-CGAT in collaboration with TWGHs JC C&A Home piloted the “EOL Program for RCHE in HKWC” program. The program offered 2 EoL care pathways on top of existing care framework: 1) AED pathway: residents remain in RCHE during last stage of life and stay there until very last moment of life; 2) FYKH pathway: resident be transferred to the hospital via expedite pathway at the last moment of life to receive hospice and palliative care until he/she passed away. The program has served 32 residents, 9 have chosen the AED pathway and two passed away peacefully in 2010. Success of this program highlights the need to examine interplaying factors in EoL care pathway and reflect on practical implications for quality EoL care. OBJECTIVE: To identify system factors that contributes to EoL care decision making and dignified EoL Care Pathways. METHOD: This is a qualitative study with individual interviews and focus groups conducted. Participants was …