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Palliative Care across Settings: Perspectives from Inpatient, Primary Care, and Home Health Care Providers and Staff.
Tietbohl, Caroline K; Dafoe, Ashley; Jordan, Sarah R; Huebschmann, Amy G; Lum, Hillary D; Bowles, Kathryn H; Jones, Christine D.
Afiliación
  • Tietbohl CK; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
  • Dafoe A; Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA.
  • Jordan SR; Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA.
  • Huebschmann AG; Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Lum HD; Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA.
  • Bowles KH; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
  • Jones CD; Ludeman Family Center for Women's Health Research, University of Colorado School of Medicine, Department of Medicine, Aurora, CO, USA.
Am J Hosp Palliat Care ; 40(12): 1371-1378, 2023 Dec.
Article en En | MEDLINE | ID: mdl-36908002
BACKGROUND: Early introduction of palliative care can improve patient-centered outcomes for older adults with complex medical conditions. However, identifying the need for and introducing palliative care with patients and caregivers is often difficult. We aim to identify how and why a multi-setting approach to palliative care discussions may improve the identification of palliative care needs and how to facilitate these conversations. METHODS: Descriptive qualitative study to inform the development and future pilot testing of a model to improve recognition of, and support for, unmet palliative care needs in home health care (HHC). Thematic analysis of semi-structured interviews with providers across inpatient (n = 11), primary care (n = 17), and HHC settings (n = 10). RESULTS: Four key themes emerged: 1) providers across settings can identify palliative care needs using their unique perspectives of the patient's care, 2) identifying palliative care needs is challenging due to infrequent communication and lack of shared information between providers, 3) importance of identifying a clinical lead of patient care who will direct palliative care discussions (primary care provider), and 4) importance of identifying a care coordination lead (HHC) to bridge communication among multi-setting providers. These themes highlight a multi-setting approach that would improve the frequency and quality of palliative care discussions. CONCLUSIONS: A lack of structured communication across settings is a major barrier to introducing and providing palliative care. A novel model that improves communication and coordination of palliative care across HHC, inpatient and primary care providers may facilitate identifying and addressing palliative care needs in medically complex older adults.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Paliativos / Pacientes Internos Tipo de estudio: Qualitative_research Límite: Aged / Humans Idioma: En Revista: Am J Hosp Palliat Care Asunto de la revista: ENFERMAGEM Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Paliativos / Pacientes Internos Tipo de estudio: Qualitative_research Límite: Aged / Humans Idioma: En Revista: Am J Hosp Palliat Care Asunto de la revista: ENFERMAGEM Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos