The Maastricht Oncology Centre at the Maastricht University Medical Centre (MUMC+) is a Comprehensive Cancer Centre in The Netherlands and the referral centre for the South-eastern part of the country. Besides the tertiary referral role, the hospital has maintained its role as a public hospital. A dedicated centre for palliative care was initiated in 1998. Activities are focused on patient care /treatment research and teaching.
The Maastricht University Medical centre has:
- 715 inpatients beds, including the beds on the oncology ward
- 26.305 admissions in 2018
- 449.797 outpatients’ consultations (including the oncology centre) in 2018
- 20.846 day-treatments in 2018
- All specialties in oncology including medical oncology, heamatology, surgery, radiotherapy, gynaecology, head and neck oncology, pulmonology, urology, dermato-oncology, gastro-intestinal oncology, genetic counseling
- Tumour Boards and multidisciplinary teams of cancer specialists
- Radiotherapy (MAASTROclinic)
- Radiologist intervention techniques
- Bone Marrow transplant unit
- Imaging services
- Comprehensive multidisciplinary University Pain Centre (in and outpatients)
- Endoscopy centre
- Multidisciplinary team for psychosocial oncology
- Multidisciplinary palliative care team
Areas of specialisation
Dedicated multidisciplinary teams treat, perform research and teach in the fields of all common and rare solid tumors as well as heamato-oncological malignancies. Top referent specialised care is available for breast cancer, head and neck cancer, colon cancer, phase I/II treatment, gynecological tumours and neuro-oncology. Medical oncology is involved in translational research, pharmacology and phase I/II studies, immunology and targeted therapy, quality of follow-up care, infertility, and care for young patients. The palliative care research is focused on (neuropatic) pain treatment, telemedicine, dyspnoe and advanced care planning.
Palliative and supportive care
The MUMC+ is one of the eight Expertise Centres of Palliative Care in The Netherlands. The eight university hospitals in the Netherlands work together on
research, education and patient care in order to improve the quality of palliative care. In the MUMC + all newly-diagnosed patients are discussed in weekly tumor-specific multidisciplinary meetings before the first treatment is started, and thereafter at every treatment decision point.
In the outpatient ward, care is organised around the patient – with doctors, nurses and other caregivers brought together. Closely-integrated oncology care ensures a timely work-up and treatment, in a warm patient-oriented environment. Palliative care, psychosocial care, pain treatment and other forms of supportive care are interwoven in all tumor-specific care lines. Members of the psychosocial care team, the pain team and the palliative care team work closely together.
At both the outpatient and inpatient wards, palliative care doctors, specialised nurses, anaesthesiologists, psychologists, psychiatrics, social workers, spiritual workers and dietary consultants are available either to see the patients themselves or to support the responsible physician by giving advice on how to handle a specific problem.
Patients are screened for pain, symptoms and psychosocial problems on a regular basis. The Palliative Care Consulting Team (PCC) inform, support and advise professional caregivers in inpatient and outpatient settings. The team consists of specialists in internal medicine, medical oncologists, specialists in care for the elderly, oncology nurses and social workers and is available from 9:00–23:00 on weekdays and from 9:00–18.00 at the weekend. If necessary, the PCC team can ask advice from an anesthesiologist, psychiatrist, radiotherapist, pulmonologist, cardiologist, pharmacist etc.
The PCC of the MUMC+ performs more than 700 consultations per year. The team does not take over responsibility of care. The responsibility stays with the treating physician. The palliative care consultant makes an assessment of the physical, psychosocial, practical and spiritual care needs of the patient and his/her family. They will formulate advice for further policies for the medical specialist, general practitioner or (community) nurse. In the discharge letter from the medical specialist it is mentioned that the general practitioner can always ask the PCC team for advice. In many cases the palliative care consultant visits the patient once or twice in their home situation and can bridge the gap between hospital and home situation.
Every patient with poorly-controlled symptoms, despite adequate treatment in the home situation, can be admitted to the oncology ward where hospital beds are reserved for palliative care/symptom stabilisation. A dedicated team of medical specialist, nurses, social workers and a chaplain care for the palliative patients on the ward.
Daily care is delivered by the ward fellow. A weekly “big” ward round, with all oncologic and nursing staff, is supported by weekly “little” ward round with the fellow, nurses, palliative care consultant, social workers and a pastor. There is a special multidisciplinary meeting for patients in the palliative trajectory.
The philosophy is to admit patients for a short intervention programme after which the patient goes back to home with additional support. Upon discharge from the hospital a special team (the discharge team) explores the patients’ needs and coordinates home care. The palliative care team is invited to these cases, in order to investigate the care needs of patients and family. Together with the discharge team they discuss with the patient and family the possibilities for home or hospice care. The palliative care team is very active in the education of nursing and medical students and staff, general practitioners, specialist in care for the elderly etc. and performs more than 70 teaching activities per year. Three researchers are performing research on pain, dyspnoe and advanced care planning.