Search results for ‘Subject term:"palliative care"’ Sort:
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Towards accessible integrated palliative care: perspectives of leaders from seven European countries on facilitators, barriers and recommendations for improvement
- Authors:
- DEN HERDEN-VAN DER EERDEN Marlieke, et al
- Journal article citation:
- Journal of Integrated Care, 25(3), 2017, pp.222-232.
- Publisher:
- Emerald
Purpose: Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice. Design/methodology/approach: A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis. Findings: IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems. Originality/value: Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced. (Publisher abstract)
Exploring the transition from curative care to palliative care: a systematic review of the literature
- Authors:
- GARDINER Clare, et al
- Journal article citation:
- BMJ Supportive and Palliative Care, 5(4), 2015, pp.335-342.
- Publisher:
- BMJ Publishing Group
Background: UK policy guidance on treatment and care towards the end of life identifies a need to better recognise patients who are likely to be in the last 12 months of life. Health and social care professionals have a key role in initiating and managing a patient's transition from ‘curative care’ to palliative care. The aim of this paper is to provide a systematic review of evidence relating to the transition from curative care to palliative care within UK settings. Method: Four electronic databases were searched for studies published between 1975 and March 2010. Inclusion criteria were all UK studies relating to the transition from curative care to palliative care in adults over the age of 18. Selected studies were independently reviewed, data were extracted, quality was assessed and data were synthesised using a descriptive thematic approach. Results: Of the 1464 articles initially identified, 12 papers met the criteria for inclusion. Four themes emerged from the literature: (1) patient and carer experiences of transitions; (2) recognition and identification of the transition phase; (3) optimising and improving transitions; and (4) defining and conceptualising transitions. Conclusions: The literature suggests that little is known about the potentially complex transition to palliative care. Evidence suggests that continuity of care and multidisciplinary collaboration are crucial in order to improve the experience of patients making the transition. An important role is outlined for generalist providers of palliative care. Incorporating palliative care earlier in the disease trajectory and implementing a phased transition appear key components of optimum care. (Publisher abstract)
‘Leaders in our own lives’: suggested indications for social work leadership from a study of social work practice in a palliative care setting
- Author:
- CULLEN Anne F.
- Journal article citation:
- British Journal of Social Work, 43(8), 2013, pp.1527-1544.
- Publisher:
- Oxford University Press
In the context of calls for the social work profession to show leadership, this article reports a single site qualitative study in a specialist palliative care setting in England, which explored suggested similarities between social work practice and a recently developed model of ‘servant and partner’ leadership. The research showed that social workers demonstrated integrity in their dealings with both service users and colleagues, in that they were both respectful and holistic. It indicated that social workers used insights gained by engaging at depth with service users to influence decision making within the multidisciplinary team of which they were members. By drawing on sophisticated and adaptive communication skills and genuinely valuing others' contributions, they enhanced the ability of the team to achieve proportionate responses to sensitive and complex situations. The article suggests that social workers in this setting exercised leadership, in the sense of influencing the practice of others at the level of individual cases and more generally, and that this was achieved by practices that were based in established theoretical models of social work. (Publisher abstract)
Full interaction at the end of life
- Author:
- ADDICOTT Rachael
- Journal article citation:
- Health Service Journal, 27.1.11, 2011, pp.24-25.
- Publisher:
- Emap Healthcare
Drawing on a recent King's Fund report, this article highlights four broad themes that are key in good quality end of life care. Identification of needs, better communication, coordinating care, and adopting a whole systems approach are all discussed. The article also emphasises the multidisciplinary nature of end of life care.
Developing a nurse led hospice outpatient clinic to improve palliative care services
- Author:
- LAWTON C.
- Journal article citation:
- Nursing Times, 31.8.10, 2010, pp.18-20.
- Publisher:
- Nursing Times
A team of palliative care clinical nurse specialists at the Phyllis Tuckwell Hospice in Farnham Surrey, set up a hospice based outpatient clinic to improve services for patients with cancer. The clinic gave nurses the opportunity to optimise patient choice and reduce anxiety, in line with the Gold Standards Framework. The use of clinical audit, a staff questionnaire and patient feedback to evaluate the services and make recommendations for its future development is described.
Why do patients with complex palliative care needs experience delayed hospital discharge
- Authors:
- THOMAS Catherine, RAMCHARAN Angie
- Journal article citation:
- Nursing Times, 29.6.10, 2010, pp.15-17.
- Publisher:
- Nursing Times
The case notes of 40 patients at North Middlesex Hospital were examined to discover why patients with complex palliative care needs often experience delays in hospital discharge. The audit revealed a variety of reasons for delayed discharge, including: delays in organising care packages; difficulties in obtaining equipment; poor communication between hospitals and primary and social care; and poor coordination of paper work. Recommendations were made and implemented, and a repeat audit is planned to assess their effectiveness.
Developing leadership in rural interprofessional palliative care teams
- Authors:
- HALL Pippa, et al
- Journal article citation:
- Journal of Interprofessional Care, 22(1S), June 2008, pp.73-79.
- Publisher:
- Taylor and Francis
This project brought together community-based practitioners and academics to develop and deliver interventions designed to enhance the leadership abilities of the designated leaders of seven rural/small town-based palliative care teams. Members of these community-based teams have already gained recognition for their teams' leadership and service delivery in their communities. All of the teams had worked closely with most members of the academic team prior to this project. The team members participated in a needs assessment exercise developed by the Sisters of Charity of Ottawa Health Service and University of Ottawa academic team. Results of the needs assessment identified leadership qualities that had contributed to their success, as well as their needs to further enhance their individual leadership qualities. The team effort, however, was the most important factor contributing to the success of their work. The interventions developed to address the identified needs had to be adapted creatively through the collaborative efforts of both the community and academic teams. The educational interventions facilitated the integration of learning at the individual and community level into the busy work schedules of primary health care providers.
Interprofessional relationships and communication in primary palliative care: impact of the Gold Standards Framework
- Authors:
- MAHMOOD-YOUSUF Kashifa, et al
- Journal article citation:
- British Journal of General Practice, 58(549), April 2008, pp.256-263.
- Publisher:
- Royal College of General Practitioners
This article examines how the relationship between GPs and district nurses affects the quality of communication about patients' palliative care needs. This study also examines whether implantation of the Gold Standards Framework led to changes in doctor-nurse relationship. The results found adoption of the framework often resulted in earlier referral of palliative care patients to district nurses. Multidisciplinary team meetings enabled communication, sharing knowledge, discussing management problems, and keeping colleagues informed; however, arranging and maintaining such meetings was often problematic. Nurses particularly valued formal meetings while GPs generally preferred informal ad hoc dialogue.
An integrated approach to dementia care
- Authors:
- KIM Kye Y., WOOD Brian E.
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 6(2), May 2007, pp.295-299.
- Publisher:
- Sage
The author provide a brief overview of the services provided by the Dementia Care Program at the Salem VA Medical Center in the United States, which provides comprehensive and seamless services to older veterans and their families. The program covers outpatient care, respite care, inpatient care and end-of-life care, all provided by the same interdisciplinary team. The program could serve as a model for dementia care in the Veteran Association health care system or other public sector systems, particularly where a need for integration of clinical care delivery in a training and research environment exists.
Identity politics in multiprofessional teams: palliative care social work
- Author:
- PAYNE Malcolm
- Journal article citation:
- Journal of Social Work, 6(2), August 2006, pp.137-150.
- Publisher:
- Sage
This article examines how post-modern and social construction views of identity creation offer opportunities for understanding identity creation when applied to social work multiprofessional teams in palliative care social work. They provide complex understandings that allow for ambiguities in identity creation. A personal and social self interacting create identity, emerging from social relations. Professional identity thus emerges from the interaction between personal identity and collective professional identities. Ascription of social and professional identities by powerful social groups is resisted, but identities emerge in identity politics among professional groups in social situations. In a client-worker-agency interaction cycle, multiprofessional interactions in communities of practice lead individual professionals to negotiate knowledge to form specialized roles such as palliative care social work. These then influence wider professional identities. Rather than seeking to maintain established professional identities, the author argues that workers may more effectively develop their professional identity by negotiating knowledge and demonstrating practice in multiprofessional teams.