In Ecuador, hospice and palliative care are relatively new concepts. In the past, patients diagnosed with a terminal illness were sent home without further treatment, pain medication or instructions for caregivers. Improving global health care of the terminally ill and educating those who care for the terminally ill is of international interest. A hospice and palliative care organization in southwest Ohio, along with an international nonprofit organization, partnered together to develop a palliative care international exchange program. The international exchange program's purpose is to educate the community, healthcare students, and medical staff in Cuenca, Ecuador in the care of their terminally ill patients. This palliative care international exchange program promotes medical, psychological, and spiritual care in southern Ecuador. The program’s success is due to both the hosts and guests benefiting from the experience.
The palliative care international exchange program provides twice yearly training workshops which focus on the philosophy of palliative care, as well as detailing the latest advances and critical issues facing end-of-life care. The palliative care training workshops prepare medical professionals, auxiliary medical staff, social workers, psychologists, chaplains, and students in caring for the terminally ill.
The training session workshops deliver the necessary program elements by incorporating the effective use of interdisciplinary team members. The training sessions are divided into two groups to better provide training at the level of understanding of those attending. Group 1 includes doctors, nurses, and psychologists. Group 1 training sessions have two modules and 64 contact hours of training. Group 2 includes certified nursing assistants and all other disciplines. Group 2 trainings include two modules and 40 contact hours of training. The depth of educational need reaches from bed bath and positioning a patient, to psychosocial support, to volunteer education, to pathophysiology and pharmacology.
The training workshops incorporate the five “R’s” as described in The Ecuador Project: the five “R’s” of an education collaboration (Palmer & Bracken, 2009). Palmer & Bracken (2009) note that there are five “R’s” that guide an international educational exchange program: realistic goals, repetition, reinforcement, reassessment, and remaining open to change. The goal of the palliative care exchange program is to educate the Ecuadorian community on providing excellent care to the terminally ill patient, not an imitation of American hospice and palliative care delivery. Values defining the foundation for hospice and palliative care in one culture may not be the same for another. This basic goal provides the framework for the formation and implementation of the training workshops.
The palliative care international exchange program demonstrates a successful cultural exchange of staff over the past 4 years. Positive changes have been observed along with improved hospice and palliative care in Cuenca Ecuador. Despite the language and cultural differences lasting relationships in an international setting have been established.
This presentation will outline the approach to establishing a sustainable international exchange program; focusing on necessary program elements, effective use of interdisciplinary team members, and “the 5 R’s” of an education collaboration. Program elements include identifying needs, champion support, processes and building networks. This presentation will explore the unique contributions of all team members. Most importantly, this presentation will focus on the fundamental importance of building relationships, which is essential for all other steps leading to success.