The Palliative Medicine Unit (PMU) is organized as one patient unit with twelve beds and one ambulant team responsible for home visits, hospital patient consultations (in other units at St. Olav University Hospital) and consultations directed at the primary care service in municipalities within the region. The ambulant role and patient in-home consultations take place in close collaboration with primary health care services. In addition the unit has a counseling role within the entire region, sometimes also nationally and internationally due to its pioneering advantage as being Norway’s first palliative care unit (established 1994).

PMU has joint responsibility with the municipality of Trondheim for twelve palliative beds in Havstein nursing home. The institution is run by the municipality of Trondheim, but is co-funded by St. Olav University Hospital. The PMU has shared responsibility for patient treatment and care.

Currently the PMU employs four senior doctors and one head of department (who is also Professor in Palliative Medicine) in addition over 50 nurses of which the majority has additional training in cancer treatment, psychology and geriatrics. In addition the section has physical therapists, one chaplain, one nutritionist and one social worker. The social worker can assist relatives of patients with practical issues such as public financial support, leave of absence and other welfare support schemes.

Clinic

The PMU treats patients with particular palliative care needs. The most complex cases are admitted for further diagnostics, treatment and care. There is a great deal of dynamics and flexibility between the ambulant team and the inpatient unit and there is a focus on close collaboration with primary healthcare services. Multiple patients have cancer related problems which requires collaboration with other oncology specialists from the main cancer unit, and surgeons from the hospital. We have a close collaborative effort with the pain center at St. Olav University Hospital.

The need for clinical expertise in palliative care in a basic necessity in order for a special unit with relatively few beds to perform at an optimal level. This includes all staff, including doctors and nurses, but also the other professions represented with only one person such as chaplain, social worker, nutritionist etc. Top-notch expertise is necessary to maintain a high professional standard and a world-class service for patients and their close relatives.

We treated 1172 patients in 2005, and had 194 visits to patients homes. Our bed usage rates are high (88%) given the limited number of beds (12). The average patient stay is 10.5 days, and our aim is to keep this as short as possible.

Education

Two senior doctors have completed the joint Nordic Specialist Course in Palliative Care, and one started at the 2009-2011 course. We aim to contribute to the promotion of palliative care in our region and we conduct courses, seminars and training sessions for health care workers. Staff from the PMU contributes with lectures at the Norwegian University of Science and Technology (NTNU) and daily training of home care nurses. Nursing students often wish to undergo practical training at PMU and we attempt to accommodate as many as possible.

Research

The PMU is active within an extremely competitive and active research community. We have established a research group in collaboration with the pain centre, namely the “Pain and Palliation Research Group”. The group utilizes the vast amount of patient data from the PMU and the cancer unit as an important resource in order to answer central research questions. We conduct clinical and translational research within pain and palliative care focusing on e.g. the understanding of complex psychosocial infractions amongst patients, new drugs trials and computerized symptom assessment and registration.

In 2009, no less than twenty-eight articles were published in peer-reviewed journals. Numerous abstracts were presented at international conferences. Professor Stein Kaasa received King Olav V’s research award in 2005 for his long devotion to improving patient care through research. Kaasa has also been appointed Cancer Director in Norway, enabling him to work even more closely with political and legislative authorities. In the autumn of 2009, the European Palliative Care Research Centre was officially opened in Trondheim. For further information, please visit www.ntnu.no/prc