BACKGROUND: An electronic Palliative Care Summary (ePCS) is currently being implemented throughout Scotland to provide out-of-hours (OOH) staff with up-to-date summaries of medical history, patient understanding and wishes, medications and decisions regarding treatment of patients requiring palliative care: automatic twice daily updates of information from GP records to a central electronic repository are available to OOH services. AIMS: To identify key issues related to the introduction of ePCS from primary care and OOH staff, to identify facilitators and barriers to their use, to explore the experiences of patients and carers and to make recommendations for improvements. METHODS: Twenty-two semi-structured interviews were carried out with a purposive sample of health professionals [practice nurses (3 interviews), GPs (12 interviews), a practice manager (1 interview) from practices using different computing software systems] and patients and/or carers (6 interviews for whom an ePCS had been completed). Interviews were digitally recorded, transcribed and analysed thematically. RESULTS: Patients and carers were reassured that OOH staff were informed about their current circumstances. OOH staff considered the ePCS allowed them to be better informed in decision making and in carrying out home visits. GPs viewed the introduction of ePCSs to have benefits for in-hours structures of care including advance care planning. No interviewee expressed concern about confidentiality. Barriers raised related to the introduction of new technology including unfamiliarity with the process, limited time and information technology skills. CONCLUSIONS: The ePCS has clear potential to improve patient care although several implementation issues and technical problems require to be addressed first to enable this. GPs and community nurses should identify more patients with malignant and non-malignant illnesses for completion of the ePCS.
BACKGROUND: An electronic Palliative Care Summary (ePCS) is currently being implemented throughout Scotland to provide out-of-hours (OOH) staff with up-to-date summaries of medical history, patient understanding and wishes, medications and decisions regarding treatment of patients requiring palliative care: automatic twice daily updates of information from GP records to a central electronic repository are available to OOH services. AIMS: To identify key issues related to the introduction of ePCS from primary care and OOH staff, to identify facilitators and barriers to their use, to explore the experiences of patients and carers and to make recommendations for improvements. METHODS: Twenty-two semi-structured interviews were carried out with a purposive sample of health professionals [practice nurses (3 interviews), GPs (12 interviews), a practice manager (1 interview) from practices using different computing software systems] and patients and/or carers (6 interviews for whom an ePCS had been completed). Interviews were digitally recorded, transcribed and analysed thematically. RESULTS:Patients and carers were reassured that OOH staff were informed about their current circumstances. OOH staff considered the ePCS allowed them to be better informed in decision making and in carrying out home visits. GPs viewed the introduction of ePCSs to have benefits for in-hours structures of care including advance care planning. No interviewee expressed concern about confidentiality. Barriers raised related to the introduction of new technology including unfamiliarity with the process, limited time and information technology skills. CONCLUSIONS: The ePCS has clear potential to improve patient care although several implementation issues and technical problems require to be addressed first to enable this. GPs and community nurses should identify more patients with malignant and non-malignant illnesses for completion of the ePCS.
Authors: Marilyn Kendall; Bruce Mason; Natalie Momen; Stephen Barclay; Dan Munday; Roberta Lovick; Stella Macpherson; Euan Paterson; Paul Baughan; Paul Cormie; Peter Kiehlmann; Amanda Free; Scott A Murray Journal: Fam Pract Date: 2013-02-04 Impact factor: 2.267
Authors: Bruce Mason; Susan Buckingham; Anne Finucane; Peter Hutchison; Marilyn Kendall; Hazel McCutcheon; Lorna Porteous; Scott A Murray Journal: BMC Fam Pract Date: 2015-12-10 Impact factor: 2.497
Authors: Bart Schweitzer; Nettie Blankenstein; Willemjan Slort; Dirk L Knol; Luc Deliens; Henriette Van Der Horst Journal: Scand J Prim Health Care Date: 2016-04-19 Impact factor: 2.581