Regional Report - Israel
Prof. Pesach Shvartzman, an IAHPC Board Member

A message from an IAHPC Board Member

Palliative Care Training - The Israeli National INPACT Experience

Many countries have recognized palliative care as an integral part of their developed health system. Implementation of such a decision requires a clear governmental policy; organizational infrastructures in the community, nursing homes, and hospitals; meeting equipment and medication requirements; and of course a curriculum to train appropriate personnel.

Countries should develop and implement educational programs for multidisciplinary health care teams at all levels of care so as to be able to expand the scope and quality of palliative care provided at the end-of-life to terminal patients and their families. Basic primary palliative care should be able to be provided by any member of the medical team (family physician, oncologist, geriatrician, neurologist, nephrologist, internal medicine physician, pediatrician, nurse, social worker, psychologist, etc.), whereas secondary palliative care should be provided by specialized palliative care teams.

Unfortunately, currently in Israel as in many other countries, both the undergraduate and postgraduate education of medical, nursing and social work students provides little if any formal training in the area of palliative care or even pain management.

In an attempt to meet the need for qualified health professionals to provide palliative care in Israel, the Israeli National Palliative Care Training (INPACT) Program was launched in 2006. INPACT is a collaborative project between academia and various health organizations: the UJA-Federation of New York, the association for the planning and development of services for the aged in Israel “Eshel”, the Israel Association of Palliative Care – “Tmicha”, the Israeli Cancer Association, the Ministry of Health, all the HMOs in Israel and the Ben-Gurion University of the Negev.

The program's structure and curriculum was developed locally, so as to be able to meet the needs of the Israeli health care system and the unique cultural heterogeneity of the Israeli society. The program addresses all health professionals (physicians, nurses, social workers and other related health providers), as these professionals are required to work within multidisciplinary teams.

An innovative ten-step-process for the development of the curriculum was undertaken: 1. Choosing the teachers/ program developers; 2. Generating themes for the program through a nominal group process; 3. Delphi/ refining the list by order of importance; 4. Prioritizing/ what must, what should, and what may be taught; 5. Negotiating/ defining inclusion of the final themes in the program and relative teaching time; 6. Defining the sequence of presentations of the course content; 7. Developing the final blueprint; 8. Writing teaching modules; 9. Assessing the teaching units; and 10. Compilation of the final program and information.
More information about this program can be found in http://fohs.bgu.ac.il/inpact.

Following this successful experience, the first “International Multidisciplinary Forum on Palliative Care" will be held on November 11-14, 2010, in Budapest, Hungary. This conference is aimed at all physicians, nurses or any other health professional interested in improving their basic palliative care skills and knowledge. Please visit the conference website for more information: http://www.imfpc.org/index.php.

Countries working to integrate palliative care throughout their health system need to provide basic palliative care training to their medical teams and in parallel train the next generation of physicians, nurses and social workers in university faculties.

To view Professor Shvartzman’s biography please go to:
http://www.hospicecare.com/Bio/shvartzman.htm

References
1.Shvartzman P. Palliative services in Israel. Gerontology 2008;35(3):67-81(Hebrew).
2.Bentur N, Resnitzky S, Shnoor Y. Palliative and hospice services in Israel – An overview. Myers -JDC Brookdale Institute, 2005, RR-459-05.
3.Guidelines for the development of palliative care services in Israel. A report by a special sub-committee, chaired by Pesach Shvartzman, of the Ministry of Health, Israel.

Address for Correspondence:
Prof. Pesach Shvartzman
Chairman, Division of Community Health
Pain and Palliative Care Unit
Ben-Gurion University of the Negev
POB 653
Beer-Sheva, 84105
Tel: 972-86477429
Fax: 972-86477636
Email: [email protected]