Page 23 - Time to DeLiver: Getting a Grip on HE report 2015
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SECTION 6
Integrating multi-disciplinary care:
An opportunity to improve patient experience
• Advanced chronic liver disease patients A survey commissioned by the British Liver
Trust of liver services in Scotland identified
and their carers/family are frequently not a general lack of liver specialists, which
part of an integrated, multi-disciplinary may adversely affect management of liver
care team.29 disease. Furthermore, there was a lack of
on-site facilities or clear referral pathways to
• Patients who eventually manage to see a deal with emergency bleeding varices, which
represents a major clinical risk.30
liver specialist often receive fragmented
care that is inadequately coordinated.29 A more coordinated care approach increases
patient attendance at outpatient centres and
• Fragmented care generally occurs quality of care, compared with advanced
chronic liver disease patients who do not
between inpatient and outpatient receive appropriate care management.31
settings, primary care providers and
liver specialists.29 The EASL/AASLD guidelines underline the
need for a close liaison between the patient’s
• The EASL/AASLD guidelines (2014) family, the general practitioner, and other
caregivers in the primary health service,
underline the need for a close liaison so that all parties involved understand how
between the patient’s family, the general best to manage hepatic encephalopathy and
practitioner and other caregivers in the prevent recurrent hospitalisations.1
primary health service.1
Calls to action
Advanced chronic
liver disease • Liver patient organisations should survey
patients and their their members to better identify what
carers/family are support patients and carers would like/
frequently not part benefit from, and then either provide them
of an integrated, or campaign for health services to provide
multi-disciplinary them accordingly.
care team29
• Healthcare providers should identify how
to improve care pathways for hepatic
encephalopathy through joint working and
a shared voice scheme.
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