25 June 2019
By Mary Bermingham
Marymount University Hospital & Hospice recently launched its seven year Strategy; an ambitious but cost-effective plan to deliver excellence in caring for elderly and provision of Specialist Palliative Care Services to patients and families (Hospice).
A welcome address was given by Mr Kieran Barry, chairman Board of Directors who stated “the economic case for investment in services for older people and for specialist palliative care is well established and this strategy has been formulated to address gaps in services and to excel in the services we provide.”
Marymount’s Strategy Plan 2019-2025 has been endorsed by the HSE.
Speaking at the launch Cork Kerry Community Healthcare/Health Service Executive Chief Officer, Ger Reaney said: “Marymount University Hospital & Hospice are a valued partner of Cork Kerry Community Healthcare in the delivery of palliative and older people services. We welcome the initiative of the Board in preparing a Strategy to plan for the increasing demographic needs of both of these groups.”
Marymount chief exectuve officer, Sarah McCloskey said new evidence shows that palliative care is not only clinically effective and prolongs life, but is equally cost saving.
“Care for those with a life limiting illness is known to account for a large proportion of health care resources. In the US they have estimated that 25% of all health care expenditure is related to persons in their last year of life. In the UK they have estimated that approximately 20% of acute hospital bed days are taken up by end of life care,” she said.
“Success in palliative care addresses access/equity; it focuses on quality of life alongside complex symptom management. We know we can deliver more services, we know that it is cost effective for us to do more and we are acutely aware of the increasing demand for our services” Ms McCloskey added.
Marymount has set its strategic vision to be a world-class leader in order to meet the needs of the people they serve and to lead research and education in this area. Marymount is the oldest and largest hospice in Ireland with a history of that reflects ambition and vision. Two of the consultants were uniquely trained by the founder of the hospice movement, Dame Cisely Saunders. They have gone on to influence practice nationally and internationally including current national policy (the National advisory report 2001), which was led by Marymount’s Professor Tony O’Brien.
“Ambition is known to lead to success and Marymount intends to achieve this,” said Ms McCloskey.
Under the plan Marymount’s six key strategic goals are:
- Ensure the financial sustainability of its services
In today’s climate, there is an increasingly business focus on our approach to care delivery and Marymount will continue to work on enhancing systems for effective and efficient practices. Currently Marymount relies on various sources of funding including 58% state funding and significant fundraising endeavours. Marymount has fantastic support from the community across Cork and are most grateful for this as without it Marymount would not be able to deliver their current quantum of services.
- Develop Specialist Palliative Care (SPC)
Marymount currently has 44 inpatient SPC beds, day care service and a current caseload in the community of 550 patients and families. Marymount will further enhance its community outreach work including outpatient work, bereavement/family supports and further develop the range of palliative care services for children.
Avoidable acute hospital readmissions have been described as a marker for poor quality care. There are now a number of studies that support that SPC improves patient outcomes, including expert symptom management, clear and well communicated goals of care, more effective transitions to alternative places of care and reduced readmissions to acute hospitals. By investment in Marymount’s services for adults and children more patients will receive appropriate good quality care.
- Optimise older persons services
Marymount provides high quality inpatient services for older people evidenced by full HIQA compliance. Ireland faces the challenge of an increasing ageing population and this trend will continue with the anticipated growth in people over 65 years old expected to rise by almost 30% by 2021. Marymount will review alternative models of care provision for older people to seek opportunities to meet some of such increasing demands; including long term care models, palliative support beds, step down, convalescence and perhaps new emerging models. A review project will be undertaken scoping the potential to meet the needs of our older people and reviewing potential funding streams.
- Deliver IT strategy
Marymount have limited IT resourcing and infrastructure due to limited resourcing. But its importance and its potential is enormous in our environment. Health care technologies have the capacity to enable safer practice, e.g. through E prescribing, E Health records, enabling better access, real time data – cognisant that most of our service provision is offsite.
- Employer of Choice
Marymount recognises the importance of health and wellbeing in the workplace. The team in Marymount are undoubtedly the most invaluable asset – they are a diverse and competent interdisciplinary team. Marymount will focus on the health and wellbeing of the staff and ensure they feel valued in their work. The work can be challenging and Marymount will enable positive staff outcomes and aim to prevent problems such as burnout. This will result in positive wellbeing, leadership at every level, positive engagement and a highly skilled and compassionate workforce to enable the best possible delivery of care.
- Research and Education
Our clinical services are underpinned and completely integrated with research and education. We are the oldest training site in SPC for specialist medicine and provide interdisciplinary undergraduate and postgraduate placements. Marymount will further grow its education and research centre into a research and education institute, developing relationships further with academic partners, delivering a project for awareness and benefits of palliative care and engaging in collaborative, essential and ground-breaking research. Palliative care is a speciality that is under researched; we owe it to the community and our patients to grow this body of knowledge further. Grants and funding opportunities to support this element of our business will be actively sought.
The Strategy Plan – 2019 – 2025 was launched by Ms Ann Doherty, Cork City Mananger, who stated “it has been an honour to be affiliated with Marymount and for me to provide leadership in the development of this strategy. Marymount has a rich history, strong values and a highly motivated team. They have advised internationally on Hospice care and are now ready to achieve their next level of ambition. Marymount is ultimately an invaluable community voluntary based service; they will achieve and deliver an ambitious strategic plan – of course the continued supports of the public, the spirit of volunteerism, the HSE support and of course fundraising will be more essential now than ever”.