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Developing, Implementing, Evaluating Policies and ProceduresPolicies and Procedures are developed by each program. They cannot be imported wholesale. Although another source may be used to get a get a head-start, they always must be tailored to the individual program. Development
To develop procedures, evaluate the functions and tasks needed to make these processes effective and determine appropriate roles of staff members. A procedure assigns, prioritizes, and orders responsibilities. "For example, who does what part of the assessment, where is it recorded, what should be done with the information collected, or who is authorized to decide what to do next?". The following general areas are included in the Policy and Procedure Manual:Departmental: Address administrative issues. Most palliative care programs will be incorporated into an existing department with established administrative policies and procedures. Many of these policies may be institution-wide and can be incorporated into the program's manual. Patient Care: Policy statements can be written for functioning and patient eligibility for clinical services, provider roles and responsibilities (i.e., on-call procedure), types and administration of medications (i.e., continuous subcutaneous opioid infusion, opioid use in nonmalignant pain, application of Fentanyl transdermal patches), other treatments (i.e., conscious sedation, artificial nutrition/hydration) and end of life care. Educational: Policies can clearly outline the palliative care program's education program, including core competency requirements and orientation for new staff and volunteers. Policies may also be needed for resident rotations, fellowship programs or observer programs. Research: Research procedures may include issues such as: IRB applications, conducting drug studies, completing consent forms, guidelines for reporting adverse reactions, data entry, federal regulations, and others. After the content has been identified, the members of the interdisciplinary team begin to draft the policy and procedure documents. Contributors can anticipate how policies and procedures will impact on daily clinical practice. They will assess whether policies and procedures will make it easier and faster to provide consistent, high quality care. It is valuable to have documents reviewed by the interdisciplinary group. Optimally this is the team that will be involved in implementation. This group can also be the group who will oversee the program. Generally, institutions have a standard format or style to be used when drafting new policies and procedures. Completed policies and procedures may require review and approval by the institution. Implement policies and procedures Evaluate the effectiveness of policies and procedures As the palliative care program grows, additional policies and procedures may be needed for expanding clinical services, adopting new treatments and therapies, or for implementing new regulations.
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