Hospice Challenge

Hospice Challenge

Romania
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$1 million - $5 million
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

We want to develop hospice care practices so that they became integrate into mainstream palliative medical care, based on internationally peer-reviewed and recognized standards of care. We see the hospice care as an integrated social, spiritual and medical end-of-life care that could bring each person the dignity she or he deserves in each moment of life, despite illness or life-threat they live with.

About Project

Solution: What is the proposed solution? Please be specific!

Our hospice care approach innovate in terms of: - type of service: we aim to provide a multidiscplinary, integrated and mainframe up-streamed palliative care provided by a team composed of a medical nurse, a medical doctors and a spiritual carer and/or a pshychologist, combining home-care with respite care within in-patient units, and practical consultations held within out-patient clinics responding to the patients needs - type of hospice management: we aim to create a structural center of care that integrates both home-care unit and the in-patient and out-patients units, so that each working team for all hospice services work under same management structure, within combined informational infrastructure and in the same office-building, so that they care share information more efficiently and provide care within a better time-management - hospice typa architecture: we plan, designed and constructed hospices in Eastern European area taking consideration of both local architecture, transforming communist type buildings, structured in many small closed spaces, with no provided means for barrier-free carriers or other needed services in hospice, in useful and efficient patient-oriented buildings, where care is provided so that each patient has rapid and direct access to the carers, and barrier-free access ways enable adequate care for those coming or staying at the hospice.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

It is now our intention to build a new Hospice of Hope in Bucharest with 24 beds for adults, 10 beds for children and a teaching centre. The building will also provide a day centre, an out-patient clinic and house the home-care services team. Currently less than 5% of Romanians who need palliative care receive it. The hospice will provide, free of charge to patients: - 20 beds for adults and 10 beds for children helping 750 patients a year. - Day care facilities helping 1,200 patients a year - Home care with 5,000 home visits a year - Out-patient clinic with 4,000 consultations a year - Specialist support services for breast care, stoma and lymphedema - Social, spiritual and psychological care for patients and their family members The Bucharest hospice will also include an education centre for the training of medical and social care professionals from all over South-East Europe. Hospice is a medico-social facility or concept of care that provides holistic, multi-disciplinary care for patients of all ages with a terminal or life-limiting illness. Hospice currently exists in 123 countries in the world.
About You
Organization:
Hospice Casa Sperantei Foundation
About You
First Name

Luminita

Last Name

Ratiu

Twitter
Facebook Profile
About Your Organization
Organization Name

Hospice Casa Sperantei Foundation

Organization Phone

+40 268 474 405 / +40 268 470 495 / +40 372 730 114

Organization Address

Sitei 17A Brasov

Organization Country

, BV

Country where this project is creating social impact

, B

How long has your organization been operating?

More than 5 years

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Innovation
What stage is your project in?

Idea phase

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Romanian "Casa Sperantei" Hospice has emerged immediately after uprising against communist regime in 1989, in Romania. The medical and social system, at that moment, as well as the political structures, norms and values, were seriosly degradated and the hospice care was mainly a dream for most doctors and nurses, not to mention the patients expectations, at that times. Nowadays, the Romania's full path to European Union integration, more than 10 years later, is proud to enlist more than 20s small hospice organisation acting at community level, all them being trained and coached by the Romanian leading hospice "Casa Sperantei", now one of the governmentals reliable partners in establishing the National Palliative Program in Romania, since 2008 onward.
Hospice Casa Sperantei is currently:
- a center of excellence for the Eastern Europe area
- a quality recognized provider of hospice services (with ISO, Social Services Quality Assurance and other recognition of our standards of care)
- an initiator of the local Opioid management law, model of legislative innovation for other countries in region and neighbourhood area, too (Eastern Europe and Caucasus)
- a trainer of more than 11000 professionals in palliative care
- a care for more than 12000 children and elders in need of hospice
- a founder of the National Coalition of Palliative Care, now having 17 active members
All these has become a reality in a country where:
- less than 5% of Romanians who need palliative care receive it
- usually a family member has to give up their work to care for the patient and so the family is under huge financial strain
- according to the World Health Organisation, Bucharest only, the country capital city, should have 230 specialist palliative care beds for adults and actually has ten
- more than 5,000 people in Bucharest only die of cancer each year and thousands more with other life-threatening illnesses
- 60,000 Romanians die of cancer every year.

Share the story of the founder and what inspired the founder to start this project

The story began with Graham Perolls first visit to Romania as a tourist in 1975. A chance encounter with a young Romanian couple in the medieval City of Brasov led to a lasting friendship and a deep interest in Romania. He returned several times throughout the seventies, and on these visits began to notice a progressive decline in people’s living standards due to the absurd policies of the communist regime. Then for some years he was unable to visit Romania, due to family and work commitments. In 1980, his father, Norman, died from cancer at St Christopher’s Hospice, and the care he received during his illness inspired him to set up a hospice charity in his home town. Consequently he became very involved in the hospice movement. He returned to Romania immediately after the Romania’s uprising in 1989, and on seeing at first hand the appalling conditions in the cancer hospital and the local orphanage, he knew that he must do something to help. After a few months, he sett up a hospice in the UK, to pioneer hospice care in Romania, the ‘Hospices of Hope’. The funds raised through its Romanian Appeal allowed him to raise awareness of hospice care in Romania, which was hugely successful. People from all fields were united in their newfound interest in the hospice movement. Following this, Casa Sperantei (or ‘home of hope’ in Romanian) was founded. Hospice Casa Sperantei has been since, the leading provider of hospice in Romania since 1992 and opened Romania’s first in-patient hospice in Brasov in 2002 which has been declared a Centre of Excellence for Central and Eastern Europe.

Social Impact
Please describe how your project has been successful and how that success is measured

Hospice Casa Sperantei is a non-profit NGO. It is registered in Romania as a charity foundation, number 9774 / 1992.
Hospice Casa Sperantei has the vision that all children and adults in Romania facing life-threatening illnesses, and their families, should have free access to specialised palliative care services.
Hospice is a medico-social facility or concept of care that provides holistic, multi-disciplinary care for patients of all ages with a terminal or life-limiting illness.
Hospice Casa Sperantei
- has been pioneering palliative care in Romania since 1992
- was declared one of five Centres of Excellence in Palliative Care following a study of 475 services in 28 countries across Central and Eastern Europe
- is the leading provider of palliative care in Romania
- has cared for over 12,000 children and adults suffering from terminal or life-limiting illnesses and provided support to their families
Our Vision is of a future where all terminally ill patients in Romania and surrounding countries are able to live and die with dignity as respected and valued members of their society.
In Romania, 75% of people reach the terminal stage of their illness before seeing a doctor. Despite the immense success of our own hospice services and others that have since been founded in the country, still 90% of terminally ill people die at home with little support or pain relief.
The World Health Organisation recommends a total of 230 specialist palliative care beds for Bucharest: there are currently NONE!
Hospices of Hope currently provides a hospital and home visiting service in the Bucharest City and has also recently opened an out-patient clinic. This project details on our intention to built a 30 bed in-patient hospice in Bucharest in 2012-2013. Since its establishment the hospice in Romania has cared, in Bucharest and Brasov region, for more than 12,000 adults and children and trained more than 11,000 healthcare professionals.
It is now our intention to build a new Hospice of Hope in Bucharest with 30 beds for both adults and children, and a teaching centre. The building will also provide a day centre, out-patient clinic and house the home-care services team, integrating all services around the patient-oriented hospice care and their needs.
The hospice will also include an education centre for the training of medical and social care professionals in palliative care from all over South East Europe. It is also the intention to provide a school for the child patients as the majority of them are unable to attend normal schools. Teachers are often reluctant or unprepared to have such a responsibility and parents can be over-protective. A specialist teacher will be employed. Our patients often require constant support from a family member who consequently is unable to work and earn an income. Therefore, many of our patients and their families face financial difficulties.

Our aim is to commence building work in 2012 and to open the building early in 2013. The project is scheduled, land has been purchased, the architect has drawn plans and building permits are being applied for. It is forecasted that the building permits will be obtained in autumn 2011 and the hospice will be built by June 2013. This depends on the necessary funds being secured in time. The tender process will begin in August 2011 and the scheduled start for building is March 2012. For this project €2,179,415 of firm commitments have been made and a further €388,600 have been pledged verbally, committed by private donations, grants/subsidies, corporate backing, and other fundraising ways, like fundraising events. For the next 3 years (2011-2013) the project still requires a total of €2,171,110.
The remaining money is to cover:
• the construction phase
• equipping the building and training and recruiting staff
• running costs and staff costs for the first 9 months of operation

How many people have been impacted by your project?

1,001- 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

Land acquisition-Completed
Obtaining Building Permit -Due to Autumn 2011
Tender process *construction phase -Due to Autumn 2011
Start building the hospice -Due to March 2012
Info-Campaign -Ongoing

Task 1

Administrative support for land acquisition, tendering process, obtaining building permit, other necessary permits. Ongoing meetings with local administrative public officer for guidance and support.

Task 2

Executing plans and construction of the building. Ongoing feedback from patients and local community integrated in plans. Local community support and voluntary involvement.

Task 3

Campaigning Phase. Campaigning to promote the hospice and fundraising for running costs and staff costs.

Identify your 12-month impact milestone

30 beds (adults and children)
750 patients/year
1200 patients/year in day-care center
5000 home-care visits/year
4000 clinical consultations/year
Breast, stoma and lymphedema specialist care

Task 1

Construction Phase. Land acquisition and Construction of the Building. Acquisition of medical equipment and office furniture.

Task 2

Training Phase. Training and recruiting the hospice team. Professional orientation.

Task 3

Campaigning Phase. Campaigning to promote the hospice and fundraising for running costs and staff costs.

How will your project evolve over the next three years?

The new hospice in Bucharest will serve the population in capital city in need of palliative care. Population is Bucharest city and neighbourhood areas are increasingly developing cancer-related illness, a large part of them being life-threatening, for which hospice care is needed. The centre will provide direct integrated services, such as social care, medical care, spiritual care, alongside training courses for professional development of doctors and nurses seeking to offer specialised palliative care in hospice or other settings. The centre will also be able to respond to the training needs in neighbourhood countries, such as Serbia, Montenegro, Bulgaria, that were previously trained at Brasov, Romania, or in United Kingdom, considerable reducing the training costs and efficiency.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

Integrating palliative care as public health services raises several legal and procedural challenges.
The major concern relates to recognizing the palliative care services as public health services, and to fund them from the public health funds. To date, due to lobby and advocacy efforts made by Hospice Casa Sperantei Foundation, the National Health Insurance House has already signed funding agreement for palliative care services offered by the Hospice Casa Sperantei Foundation in Brasov (one in-patient unit and one out-patient unit) and will further sign for the Bucharest (one out-patient unit), after accreditation obtained.
There are also legal and communication challenges of palliative care while considering the inclusion of a standardized mechanism to ensure a seamless transitioning of a patient from curative treatment to palliative care. Reffering patients from hospitals to a in-patient or out-patient unit, or for home based palliative care, must be done in accord with a standardized methodology. The project will facilitate work to design and finalise the methodology, in consultations with all process stakeholders.
Integrating palliative care education in the public education system stand as another project challenge. Legal recognition of continuous medical education in preparing specialists for the services provided by in-patient and out-patient units are already in place. Home-based palliative care services provided by mobile teams are under process to be included in the National Health Framework to enable recognized medical education for nurses providing this particular type of service.

Tell us about your partnerships

Ministry of Health - Public Health Authority in Romania, through the Department for Politics, Strategies and the Quality Management
The Moh works closely with HCS Foundation since introduction of first palliative care service in country, concluding with the Partnership signed at the beginning of the year 2008 to develop and implement the National Plan of Palliative Care in country. To date, Moh and HCS have drafted out the Plan and are currently working to finalising its objectives and indicators accordingly with identified needs and opportunities for specialised palliative care services throughout the country. They are our constant partner in our efforts.
Hospices of Hope - NGO in United Kingdom of Great Britain
Hospices of Hope is the main partner and founder of Hospice Casa Sperantei Foundation, registered as a charity in Otford, Kent, UK, whose mission was, since 1992 to improve the quality of life for Romania's terminally ill citizens.

Explain your selections

€2,179,415 of firm commitments have been made and a further €388,600 have been pledged verbally., through Private donations, Grants/subsidies, Corporate backing, and Other: like Events. The majority of funds that have been committed so far have been through corporate sponsorship. However, we have also received some donations from private individuals, friends and families of our former patients, and grants from Foundations, and we have organised fund-raising events such as a ball. The National government is supporting us with part of the running costs for our social services, also with inclusion in the national palliative care policies of our recommendations made after years of local experience.

How do you plan to strengthen your project in the next three years?

The project actively contributes to the implementation of the National Palliative Care Plan, a plan that enforces the European policies and measures established in the Rec(2003)24 for Romania. It also promotes international networking by creating, without precedent in Romania, an expertise transfer between a non-profit charity runing palliative care services in Romania, and the scientific opinion of the experts working with the Romanian Ministry of Health, actively engaged in supervising the establishment of palliative care services within the oncological hospitals in Romania. This project involves a public-private partnership among civil society offering quality palliative care services in Romania and public institution who are to adopt this model for its inclusion in the governmental hospital structures. A distinct component of this project intend de design and develop tailored palliative care services for rural areas in neighborhood Bucharest, directly reducing poverty and other economical and social burden on people in need living in these resource-constraint areas.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

Lack of physical access to care/lack of facilities

SECONDARY

Lack of access to targeted health information and education

TERTIARY

Lack of affordable care

Please describe how your innovation specifically tackles the barriers listed above.

We will build an in-patient teaching hospice in Bucharest to help care for the thousands of people in Bucharest facing life-threatening illnesses each year. We will provide, free of charge: 20 beds for adults + 10 beds for children for 750 patients/year, Day care facilities fpr 1200 patients/year, Home care with 5000 home visits/year, Out-patient clinic with 4000 consultations/year, Specialist support services for breast care, stoma and lymphedema, Social, spiritual and psychological care for patients and their family members. The hospice will also include an education centre for training the medical and social care professionals in palliative care from all over South East Europe.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

SECONDARY

Influenced other organizations and institutions through the spread of best practices

TERTIARY

Grown geographic reach: Multi-country

Please describe which of your growth activities are current or planned for the immediate future.

The palliative care is a public health issue and the project directly contributes to elaboration and implementation of the National Plan for Palliative Care, a plan that Romanian Ministry of Health is coordinating in direct partnership with the Hospice Casa Sperantei Foundation, reducing this public health issue's impact on the national population in Romania. This project is accountable to reach out significant parts of the targets already set in the current draft of the Plan, through extension of its international recognized direct services within Bucharest and nearby region, and through leveraged capacity of specialised continuous medical training for doctors and nurses within the south, south-est border of Romania, closer to Bucharest (Serbia, Macedonia, other countries in region).

Do you collaborate with any of the following: (Check all that apply)

Government, Technology providers, NGOs/Nonprofits, For profit companies, Academia/universities.

If yes, how have these collaborations helped your innovation to succeed?

The Romanian Ministry of Health works closely with HCS Foundation since introduction of first palliative care service in country, concluding with the Partnership signed at the beginning of the year 2008 to develop and implement the National Plan of Palliative Care in country. Our services are partially funded through governmental funding. Technology providers, NGOs, and universities further cooperates with HCS Foundation in in supervising the establishment of appropriate palliative care services and improving healthcare, through technology transfer, informational exchange or share of best practices. For profit companies are largely supporting our fundraising efforts in building the new hospice and for our other hospice needs, in country.

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