scholarly journals 69 Exploring learners’ perspectives of a pediatric palliative care tele-mentoring and education program (project ECHO) in a resource-limited setting

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e29-e29
Author(s):  
Emily Evans ◽  
Megan Doherty ◽  
Shokoufeh Modanloo ◽  
Jennifer Rowe ◽  
Dennis Newhook ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
South Asia ◽  
Healthcare Professionals ◽  
Pediatric Palliative Care ◽  
Learning Resources ◽  
Resource Limited Settings ◽  
Project Echo ◽  
Resource Limited ◽  
One Year

Abstract Introduction/Background More than 98% of children who need palliative care live in low- or middle-income countries where access to palliative care is extremely limited. A lack of palliative care education for health care providers has been identified as a significant barrier to improving access to palliative care. Project ECHO (Extension of Community Healthcare Outcomes) is an online tele-mentoring educational platform developed to improve access to specialist care in these underserved areas. From 2018 to 2019, we piloted a one-year Project ECHO program which provided pediatric palliative care training for healthcare professionals mainly within India and surrounding South Asian countries. Objectives The objective of this study was to explore the learning experiences of participants in a Project ECHO on pediatric palliative care in South Asia and explore considerations to improve ECHO to cater to the unique learning needs and challenges for healthcare professionals in resource-limited settings. Design/Methods We implemented a one-year Project ECHO targeting healthcare providers in South Asia, which consisted of 24 bi-weekly 90-minute sessions. Learners who attended at least 20% (5 sessions) were invited to participate in focus groups. Focus groups were designed to explore participants’ experiences and the perceived strengths and weaknesses of the program. Recordings of the focus group sessions were transcribed, coded and independently verified. The codes were then arranged into overarching themes. Results Seventeen individuals from India and Bangladesh participated in four focus groups at the end of ECHO PPC. Following coding and analysis, two major themes and seven sub-themes were identified. The themes included: (1) Benefits of participation in ECHO PPC (creation of a community of practice; opportunity to exchange cultures, ideas and experiences; supportive role of the facilitator and peers; increased relevant knowledge and skills; and access to additional learning resources) and (2) Barriers to participation (difficulties with time and practice schedule management; and language and sociocultural factors). Conclusion Healthcare professionals in resource-limited settings benefit from project ECHO through the creation of a supportive, online learning community of peers where ideas, experiences and learning resources can be shared. Addressing barriers to participation may enhance the learning experience of project ECHO in the future.

scholarly journals Using Virtual Learning to Build Pediatric Palliative Care Capacity in South Asia: Experiences of Implementing a Teleteaching and Mentorship Program (Project ECHO)

2021 ◽  
pp. 210-222
Author(s):  
Megan Doherty ◽  
Spandana Rayala ◽  
Emily Evans ◽  
Jennifer Rowe ◽  
Vineela Rapelli ◽  
...  
Keyword(s):  
Palliative Care ◽  
South Asia ◽  
Virtual Learning ◽  
Pediatric Palliative Care ◽  
Healthcare Outcomes ◽  
Resource Limited Settings ◽  
Project Echo ◽  
Resource Limited ◽  
The Impact ◽  
Improve Access

Palliative care is an important component of pediatric cancer treatment that provides holistic support for children and their families. In low- and middle-income countries, where 98% of the children needing palliative care reside, access to palliative care services is often very limited. Training opportunities for healthcare professionals are essential to improve access to palliative care in these settings. Virtual learning, which brings training and mentorship directly to learners, can improve access to educational opportunities for staff in resource-limited settings. In this report, we describe a novel and evolving model of building pediatric palliative care (PPC) capacity in South Asia. We describe the design, implementation, challenges, and subsequent modifications of our program, as well as the impact of the program for participants and for PPC service delivery in South Asia. Our teleteaching and mentoring program (Project ECHO) [Extension for Community Healthcare Outcomes] consisted of biweekly videoconference sessions with didactic teaching and case-based discussions. The program focused on engaging participants in meaningful learning by focusing on opportunities for participant interaction through teachings and case discussions. Participants identified the program as particularly beneficial for improving their knowledge and confidence in managing seriously ill children. Project ECHO is a novel model of building PPC capacity that is suitable for resource-limited settings. Key modifications to the Project ECHO model include a course-specific leadership team, developing learning plans to address the specific learning needs of participants, focusing on ensuring learner participation during sessions, and using social media and electronic resources to create opportunities for further learning outside of ECHO sessions. These adaptations may improve the efficacy of Project ECHO and others using virtual learning programs in resource-limited settings.

scholarly journals Exploring Health Professionals’ Experiences With a Virtual Learning and Mentoring Program (Project ECHO) on Pediatric Palliative Care in South Asia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110430
Author(s):  
Megan Doherty ◽  
Shokoufeh Modanloo ◽  
Emily Evans ◽  
Jennifer Rowe ◽  
Dennis Newhook ◽  
...  
Keyword(s):  
Palliative Care ◽  
Online Education ◽  
South Asia ◽  
Learning Community ◽  
Health Care Providers ◽  
Qualitative Description ◽  
Pediatric Palliative Care ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Project Echo

Project ECHO (Extension of Community Healthcare Outcomes) is an innovative model of online education which has been proposed to enhance access to palliative care in resource-limited settings. There is limited literature describing how health care providers in low-and middle-income countries benefit from and learn from this type of training. This qualitative description study explores the learning experiences of participants in a Project ECHO program on pediatric palliative care in South Asia through focus group discussions. Discussions were transcribed, coded, independently verified, and arranged into overarching themes. We identified learning themes including the importance of creating a supportive learning community; the opportunity to share ideas and experiences; gaining knowledge and skills, and access to additional learning materials. Designing future programs to ensure a supportive and interactive learning community with attention cultural challenges may enhance learning from future Project ECHO programs.

scholarly journals Challenges of paediatric palliative care in Romania: a focus groups study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nadia Pacurari ◽  
Eva De Clercq ◽  
Monica Dragomir ◽  
Anca Colita ◽  
Tenzin Wangmo ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Paediatric Oncology ◽  
Pediatric Palliative Care ◽  
Charitable Organizations ◽  
Number Of Children ◽  
Care Services ◽  
Paediatric Palliative Care ◽  
Palliative Care Services

Abstract Background The availability of palliative care facilities for children vary considerably among the European member states. In Romania, a country where health expenditure is among the lowest in Europe, palliative care has been mainly provided by charitable organizations. Despite the high number of children needing palliative care, there is scant literature and research available on paediatric palliative care in Romania. The study explores the viewpoints of various paediatric oncology providers with regard to paediatric palliative care provision in Romania. Methods Four mixed focus groups were conducted at four university-affiliated paediatric oncology centres located in three distinct Romanian regions (Bucuresti-llfov, Nord-Est and Nord-Vest). The focus groups were analyzed using thematic coding. Results For many healthcare professionals, emotional burden inherent to the profession; unhealthy work-life balance and understaffing were among the biggest barriers to the successful integration of pediatric palliative care. The lack of staff was attributed to a shortage of financial resources, and to the persisting cultural stigma surrounding palliative care and oncology. Also political turmoil was identified as an important obstacle to palliative care implementation. Conclusion Significant barriers persist limiting the broader implementation of pediatric palliative care in Romania. In order to render palliative care in pediatric oncology more sustainable, more attention should be paid to the mental health care of healthcare professionals working in this field, to the development of mobile palliative care services and to the emigration of skilled medical staff.

scholarly journals What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne M. Finucane ◽  
Connie Swenson ◽  
John I. MacArtney ◽  
Rachel Perry ◽  
Hazel Lamberton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Psychological Needs ◽  
Care Providers ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Complex Needs ◽  
Sequential Explanatory ◽  
Palliative Care Needs

Abstract Background Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.

scholarly journals Exploring learners’ perspectives of a Project ECHO palliative care education curriculum in resource-limited settings in light of key learning theories

2020 ◽  
Author(s):  
Megan Doherty ◽  
Shokoufeh Modanloo ◽  
Emily Evans ◽  
Dennis Newhook ◽  
Doug Archibald
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Providers ◽  
Learning Theories ◽  
Sociocultural Factors ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Specialist Care ◽  
Community Healthcare ◽  
Project Echo

Abstract Background: Project ECHO (Extension of Community Healthcare Outcomes) is a well-established telehealth educational platform developed to improve access to specialist care training in underserved areas. The objective of this study is to explore the learning experiences of participants in a Project ECHO targeting care providers in India and explore considerations for how ECHO programs could be modified to cater to the unique learning needs of individuals in low- and middle-income countries. Methods : We implemented a one-year Project ECHO on pediatric palliative care (ECHO PPC) targeting healthcare providers in India. The program consisted of 24 bi-weekly sessions (March 2018-February 2019) hosted by the Hyderabad Centre for Palliative Care in Hyderabad, India. Learners who attended at least 20% (5 sessions) were eligible to participate. Data related to demographic characteristics of ECHO PPC participants were collected. Four focus groups were conducted (February-April 2019) either online via videoconference or in person. Focus groups recordings were transcribed, coded and independently verified. The codes were then arranged into overarching themes.Results : Thirty-six learners were eligible and invited to participate in the study. Seventeen individuals completed the study. Following coding and analysis, two major themes and seven sub-themes were identified. The themes included: (1) Benefits of participation in ECHO PPC (creation of a community of practice; opportunity to exchange cultures, ideas and experiences; supportive role of the facilitator and peers; increased relevant knowledge and skills; and access to additional learning resources) and (2) Barriers to participation (difficulties with time and practice schedule management and language and sociocultural factors). Conclusion: The key principals of learning theories were incorporated into forming the Project ECHO conceptual model in this study. PPC Project ECHO facilitated community building, stimulated professional interest and additional learning outside of the program. However, addressing the barriers and challenges might likely enhance the success of the program in future.

Challenges in the Provision of Pediatric Palliative Care in Mexico: A Cross-Sectional Web-Based Survey

2021 ◽  
pp. 082585972110627
Author(s):  
Elena Solveig Grüneberg ◽  
Jorge Ramos-Guerrero ◽  
Tania Pastrana
Keyword(s):  
Palliative Care ◽  
Working Conditions ◽  
Work Experience ◽  
Healthcare Professionals ◽  
Pediatric Palliative Care ◽  
Snowball Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Web Based

Objective: An enormous need for pediatric palliative care (PPC) has been reported, especially in low- and middle-income countries (LMICs). However, the access to PPC is limited. This study identifies the current challenges in the provision of PPC and their severity from the perspective of healthcare professionals. Method: We conducted a web-based descriptive cross-sectional survey among healthcare professionals treating children in need of palliative care in Mexico in 2019. We used convenience sampling and snowball sampling to acquire participants. Results: Seventy healthcare professionals from Mexico participated. Participants were 64.3% female, on average 45.8 (SD = 10.9) years old, had an average of 15.84 (SD = 10.4) years of work experience and worked in 15 states. The three most severe barriers reported were: (1) Few teams and/or networks of out-of-hospital/domestic support; (2) Absence of training centres and continuing medical/paramedical education in PPC; and (3) Lack of legal, labor, and economic protection for parents who must stop working to be with their children. The barriers related to a lack of awareness and commitment, a lack of support, legal factors, and working conditions were rated highest. Participants considered increased awareness and better knowledge of PPC for all as the top priority, and particularly emphasized the need for better education and training of health professionals. Conclusion: We have identified several barriers to successful palliative care (PC) provision for children. Primarily, these are lack of awareness and commitment, especially of the health authorities and the medical professions, lack of personal and financial support, legal factors, and working conditions. The need to change and improve care exists at the policy level, the health professional level, and the public societal level.

What’s in a name? A qualitative exploration of what is understood by “palliative care” in the emergency department

2015 ◽  
Vol 29 (4) ◽  
pp. 293-301 ◽  
Author(s):  
Jennifer Weil ◽  
Tracey J Weiland ◽  
Heather Lane ◽  
George A Jelinek ◽  
Mark Boughey ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Focus Groups ◽  
Advanced Cancer ◽  
Emergency Departments ◽  
Healthcare Professionals ◽  
Emergency Physicians ◽  
Emergency Nurses ◽  
Telephone Interviews ◽  
Palliative Care Services

Background: The understanding of what palliative care is, and which patients may benefit from palliative care, has important implications for optimal patient care in all areas of health provision. Aim: To explore the understanding of palliative care by healthcare professionals caring for patients with advanced cancer attending emergency departments. Design: Qualitative study, with two phases: the first, a series of focus groups with healthcare professionals from various disciplines and settings caring for patients with advanced cancer presenting to emergency departments; the second, semi-structured telephone interviews with emergency healthcare professionals across Australian States and Territories, including outside metropolitan centers. The data were audio-recorded and transcribed, with analysis undertaken using a qualitative thematic analysis. Setting/participants: Saturation of themes was reached after 8 focus groups (22 emergency nurses, 21 emergency physicians, 6 oncologists, 6 hospital palliative care clinicians, and 28 community palliative care clinicians) and 11 telephone interviews (8 emergency physicians and 3 emergency nurses), a total of 94 participants. Results: The overarching theme was that healthcare professionals held contradictory understandings of palliative care and its application in the emergency department; subthemes highlighted these inconsistencies when the term “palliative” is used, in understandings of and engagement with palliative care services and in perceptions about the practical utility of palliative care. Conclusion: There are entrenched contradictions and tensions surrounding the term “palliative care”; confronting these is likely to require more than re-branding, and will promote better care for this vulnerable patient group in the emergency department.

scholarly journals Covid-19 and Palliative Care Delivery in Resource-Limited Settings: Healthcare Workers’ Involvement

2021 ◽  
Vol 21 (7) ◽  
pp. 458-464
Author(s):  
Lawal Olayemi ◽  
Jyothi Alex Abraham ◽  
Vicky Yemoh ◽  
Kamoru Adedokun ◽  
Samuelu-Matthes Maatasesa
Keyword(s):  
Palliative Care ◽  
Chronic Conditions ◽  
Healthcare Workers ◽  
Preventive Measures ◽  
Care Delivery ◽  
Developed Countries ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Care Workers ◽  
Patients At Risk

As the global surge of the COVID-19 pandemic continues to rise, attention has been drawn to health implications and damaging effects caused by COVID-19 in patients with chronic conditions. Palliative care delivery in diseased patients and those with chronic conditions is imperative in mitigating unprecedented health outcomes. Though many health care workers in developed countries are implementing new strategies to address palliative care challenges in patients at risk of COVID-19, preventive measures and strategies are crucial in resource-limited settings, where palliative care is seen as a new concept. This report addresses the approach to palliative care delivery and changes that may arise from the coronavirus pandemic. It also looks at possible socio-behavioural entities, education, preventive measures and upscaling diagnostic capacity for COVID-19 in resource-limited settings. Harnessing these factors as guidance and delivery tools for healthcare workers in resource-limited settings could help to manage risks and benefits associated with providing optimal palliative care in this pandemic period. 

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