Maasstad Ziekenhuis is a general teaching hospital in Rotterdam, the Netherlands. The hospital is a member of the STZ (Dutch association of tertiary medical hospitals). In 2011 the hospital opened in a new building in the south of Rotterdam.
in 2013 the hospital had: 574 beds, 2974 employees, 203 medical specialists, 77 trainee-doctors, 28,106 admissions and 167,578 first polyclinic 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.
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:
- 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 five/six haematologists/oncologists (including two oncologists with specialised training in palliative care), two specialised nurse practitioners, two research nurses, 18 oncology nurses, (including 10 haematology nurses and two palliative care nurses), a psychologist, a psychiatrist, a spiritual carer, a social worker and a transfer nurse plus the The Palliative Care Consultation Team.
Areas of specialisation
Since 2010 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.
- The Consultation Palliative Care Team is part of the oncology centre, but offers its expertise also to the other non-oncology wards and patients (clinical and polyclinic).
- 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. A pilot has started on the ward of neurology and cardiology. In 2015 the pathway will be 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
Pallaitive and supportive care
Palliative care focuses on pro-active palliative care planning: multidimensional, multi(inter)disciplinary and methodically.
The Palliative Care Consultation Team 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
Every week there is a multidisciplinary meeting with the whole team: medical consultants palliative care (Elderly care physicians, consultant palliative medicine), nurse consultants palliative care, oncologists, neurologist, anaesthetist, spiritual carer, psychologist, social worker.
The medical palliative care consultants are member of the outpatient regional consultation palliative care team and are working in specialized high care hospice units in nursing homes.