History
Maasstad Ziekenhuis is a general teaching hospital in Rotterdam, the Netherlands. The hospital is a member of the STZ (Dutch association of top clinical hospitals).
In 2019 the hospital had: 560 beds, 3175 employees, 251 medical specialists, 182 trainee-doctors, 27,680 admissions and 138,646 first outpatient clinic visits. Maasstad Ziekenhuis offers basic care and highly specialised care (heart- and neurosurgery, burns centre, dialysis, HIV/aids, robot expertise centre, Level III Intensive Care, regional centre for gastroenterology). Activities are focused on treatment, education and research.
Profile
Part of the hospital is a cancer centre where all specialists concerned with cancer patients are based and where patients are provided with patient-centred cancer care.
The cancer centre has departments for diagnostic facilities related to cancer and special units for medical oncology, haematology echelon C, pulmonary oncology, gastro-intestinal and pancreatic oncology surgery and urogenital oncology surgery.
Multi/interdisciplinary teams/tumour boards coordinate and control the diagnostics and treatment for our patients. National Oncology Guidelines are used.
Available specialisms are:
- Radiology
- Nuclear medicine
- Radiologist intervention techniques
- Pre and post Bone Marrow transplant unit
- Imaging services
- Pain centre (in and outpatients)
- Endoscopy centre
- Multidisciplinary team for psychosocial oncology
- Ambulatory services/paramedics
- Multidisciplinary consultation palliative care team
The medical oncology ward consists of 19 beds for diagnosis, treatment (intensive post-transplant care, brief palliative interventions such as titrating pain medication, ascites drainage), an outpatient clinic and day treatment centre.
The staff consists of seven haematologists/oncologists (including two oncologists with specialised training in palliative care), three nurse practitioners, two research nurses, 18 oncology nurses, a psychologist, a spiritual carer, a social worker, a transfer nurse plus the Team Supportive and Palliative Care (TSPC). This team consists of a nurse practitioner, two specialized nurses and a palliative care doctor.
Specialities
Since 2011 palliative care has been a part of the strategy of the Maasstad Ziekenhuis. In collaboration with Learning and Teaching Centres for Palliative Care (Leerhuizen Palliatieve Zorg) there are three main goals: development, education and research to improve palliative care in the hospital. There is strong focus on collaboration with general practitioners, home care, nursing homes and the hospice (unit)s. In 2020 the Maasstad hospital received the accreditation of the Dutch association of top clinical hospitals (STZ) for supportive and palliative care.
- The Team Supportive and Palliative Care (TSPC) is part of the oncology centre, but offers its expertise also to the other non-oncology wards and patients (clinical and outpatient clinic)
- National palliative guidelines and pathways are used
- Maasstad has developed a digital Pathway Palliative Care. This pathway provides indicators for palliative care, supports the advanced care planning, the process of informed consent and structured quality of palliative care. In 2015 the pathway is implemented on all the other wards
- Research is focused on quality of palliative care
- There is a strong collaboration with the Network Palliative Care Rotterdam, in which all the relevant parties strongly work together to improve the (transmural) palliative care
- Palliative care is embedded in national and international networks
Palliative and Supportive Care
Palliative care focuses on pro-active palliative care planning: multidimensional, multi(inter)disciplinary and methodically.
The Team Supportive and Palliative Care (TSPC) is involved in complex care, characterised by:
-
limited experience or uncertainty of referring party (doctor/resident and/or nursing staff)
- complex disease (extensive metastases, risk of bleeding, wounds, (risk of) paralysis)
- complex or refractory symptoms
- complex end-of-life decisions (dilemmas: stopping in advanced, treatment withdrawal, sedation, euthanasia)
- needs of family members, cultural, ethical or legal issues
- complex sedation (in case of complex medication prior to starting sedation and for steps 2 and 3 of sedation protocol) and euthanasia
- emergency discharge home or to a hospice
- does not take over treatment, unless explicitly requested by the responsible physician
- will always contact the general practitioner and the home care team
- has five main tasks: advice, support, evaluation and verification, education, development and research
Twice a week there is a multidisciplinary meeting with the whole team: nurse consultants palliative care, oncologists, geriatrician, anesthesiologist- pain specialist, lung specialist and spiritual carer. If necessary, other specialists are involved such as neurologist, general practitioner, psychologist, social worker.
The nurse practitioner is also part of the telephone advice team of the municipality of Rotterdam for advice to general practitioners with questions about palliative care patients.
Team Members
Huijben A - Oncologist, doctor palliative care
Knegtmans M - Nurse practitioner
Blok E - Specialized nurse
Van Leijen C - Specialized nurse
Last update: February 2021
