Fien Mertens1,2,3, Zoë Debrulle4, Evelyn Lindskog4, Luc Deliens3,5,6, Myriam Deveugele7, Peter Pype3,8. 1. General Practitioner, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. 2. VUB, Belgium. 3. End-of-Life Care Research Group. 4. Ghent University, Ghent, Belgium. 5. Professor of Palliative Care Research, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. 6. Department of Family Medicine and Chronic Care, VUB, Belgium. 7. Professor em. Communication in Health Care, Psychologist, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. 8. Professor Interprofessional Collaboration in Education and Practice, General Practitioner, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Abstract
BACKGROUND: Continuity of care is challenging when transferring patients across palliative care settings. These transfers are common due to the complexity of palliative care, which has increased significantly since the advent of palliative care services. It is unclear how palliative care services and professionals currently collaborate and communicate to ensure the continuity of care across settings, and how patient and family members are involved. AIM: To explore healthcare professionals' experiences regarding the communicative aspects of inter-professional collaboration and the involvement of patient and family members. DESIGN: Qualitative design, including focus group discussions. SETTING/PARTICIPANTS: The study focused on one palliative care network in Belgium and involved all palliative care settings: hospital, hospital's palliative care unit, home care, nursing home. Nine group discussions were conducted, with diverse professionals (n = 53) from different care settings. RESULTS: Timely and effective inter-professional information exchange was considered fundamental. A perceived barrier for interprofessional collaboration was the lack of a shared electronic health record. Efficiency regarding multidisciplinary team meetings and inter-professional communication were subject to improvement.A striking study finding was the perceived insufficient open communication of specialists towards patients and the lack of shared decision making. This not only hampered advance care planning discussions and early integration of palliative home care, but also the functioning of other professionals. CONCLUSION: From the perspective of the integrated care framework, several areas of improvement on different levels of care and collaboration are identified. Support from policymakers and researchers is required to achieve integrated palliative care in regional networks.
BACKGROUND: Continuity of care is challenging when transferring patients across palliative care settings. These transfers are common due to the complexity of palliative care, which has increased significantly since the advent of palliative care services. It is unclear how palliative care services and professionals currently collaborate and communicate to ensure the continuity of care across settings, and how patient and family members are involved. AIM: To explore healthcare professionals' experiences regarding the communicative aspects of inter-professional collaboration and the involvement of patient and family members. DESIGN: Qualitative design, including focus group discussions. SETTING/PARTICIPANTS: The study focused on one palliative care network in Belgium and involved all palliative care settings: hospital, hospital's palliative care unit, home care, nursing home. Nine group discussions were conducted, with diverse professionals (n = 53) from different care settings. RESULTS: Timely and effective inter-professional information exchange was considered fundamental. A perceived barrier for interprofessional collaboration was the lack of a shared electronic health record. Efficiency regarding multidisciplinary team meetings and inter-professional communication were subject to improvement.A striking study finding was the perceived insufficient open communication of specialists towards patients and the lack of shared decision making. This not only hampered advance care planning discussions and early integration of palliative home care, but also the functioning of other professionals. CONCLUSION: From the perspective of the integrated care framework, several areas of improvement on different levels of care and collaboration are identified. Support from policymakers and researchers is required to achieve integrated palliative care in regional networks.
Authors: Theresa Sophie Busse; Sven Kernebeck; Larissa Alice Dreier; Dorothee Meyer; Daniel Zenz; Peter Haas; Boris Zernikow; Jan Peter Ehlers Journal: Int J Environ Res Public Health Date: 2022-01-01 Impact factor: 3.390