scholarly journals Development of a Managed Clinical Network for Children’s Palliative Care – A Qualitative Evaluation

2021 ◽  
Author(s):  
Andrew Papworth ◽  
Lorna Fraser ◽  
Jo Taylor
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Qualitative Evaluation ◽  
Governance Structure ◽  
Evidence Base ◽  
Care Staff ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Clinical Network ◽  
Barriers To Access

Abstract Background Consistent evidence suggests that children’s palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children’s palliative care MCN, with an aim to identify barriers and enablers of successful implementation.Methods Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children’s palliative care (September 2019-March 2020). Results The study explored health professionals’ perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN’s development was impeded by cross-cutting barriers including limited funding for the MCN and children’s palliative care more generally, no shared technology, lack of standards and evidence-base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the MCN’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. Conclusions Key features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

scholarly journals Development of a managed clinical network for children’s palliative care – a qualitative evaluation

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrew Papworth ◽  
Lorna Fraser ◽  
Jo Taylor
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Qualitative Evaluation ◽  
Governance Structure ◽  
Evidence Base ◽  
Care Staff ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Clinical Network ◽  
Barriers To Access

Abstract Background Consistent evidence suggests that children’s palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children’s palliative care MCN, with an aim to identify barriers and enablers of successful implementation. Methods Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children’s palliative care (September 2019–March 2020). Results The study explored health professionals’ perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN’s development was impeded by cross-cutting barriers including limited funding for the MCN and children’s palliative care more generally, no shared technology, lack of standards and evidence base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the MCN’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. Conclusions Key features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

scholarly journals Development of a Managed Clinical Network for Children’s Palliative Care – A Qualitative Evaluation

2020 ◽  
Author(s):  
Andrew Papworth ◽  
Lorna Fraser ◽  
Jo Taylor
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Qualitative Evaluation ◽  
Governance Structure ◽  
Evidence Base ◽  
Care Staff ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Clinical Network ◽  
Barriers To Access

Abstract BackgroundConsistent evidence suggests that children’s palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children’s palliative care MCN, with an aim to identify barriers and enablers of successful implementation.MethodsThematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children’s palliative care (September 2019-March 2020). ResultsThe study explored health professionals’ perceptions of the MCN features that helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN’s development was impeded by cross-cutting barriers including limited funding for the MCN and children’s palliative care more generally, no shared technology, lack of standards and evidence-base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the MCN’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. ConclusionsKey features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

scholarly journals Development of a Managed Clinical Network for Children’s Palliative Care – A Qualitative Evaluation

2020 ◽  
Author(s):  
Andrew Papworth ◽  
Lorna Fraser ◽  
Jo Taylor
Keyword(s):  
Palliative Care ◽  
Qualitative Evaluation ◽  
Governance Structure ◽  
Evidence Base ◽  
Care Staff ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Clinical Network ◽  
Barriers To Access ◽  
Governance Processes

Abstract Background Consistent evidence suggests that children’s palliative care is not equitable and managed clinical networks have been recommended as a solution. This study explored the development of a managed clinical network for children’s palliative care in England, with an aim to identify barriers and enablers of successful implementation. Methods Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the Network or in the delivery of children’s palliative care (September 2019-March 2020). Results The study identified Network features that helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded Network co-ordinator, committed individuals who lead the Network, and a governance structure that fosters collaboration. However, the Network’s development was impeded by cross-cutting barriers including limited funding for the Network and children’s palliative care more generally, no shared technology, lack of standards and evidence-base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the Network’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. Conclusions Key features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

scholarly journals Staff Perspectives of Barriers to Access and Delivery of Palliative Care for Persons With Dementia in Long-Term Care

2018 ◽  
Vol 33 (5) ◽  
pp. 284-291 ◽  
Author(s):  
Emily Hill ◽  
Marie Y. Savundranayagam ◽  
Aleksandra Zecevic ◽  
Marita Kloseck
Keyword(s):  
Palliative Care ◽  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Palliative Care Education ◽  
Barriers To Access ◽  
Communication Difficulties ◽  
Phenomenological Methodology

Dementia is a syndrome that is progressive, degenerative, and terminal. The palliative care philosophy aims to maximize quality of life for the dying individual and is both beneficial for and underused with persons dying with dementia. Objectives: The purpose of this study was to investigate the experiences of long-term care staff delivering palliative care to individuals with dementia to determine how care was delivered, to learn which guidelines were used, and whether policies affected the delivery of palliative care. Methods: Twenty-two staff participants were interviewed. Their experiences were interpreted using phenomenological methodology. Results: Findings yielded 3 key themes: confusion, resource shortages, and communication difficulties. Conclusion: Implications for practice include clarification of terminology surrounding palliative care, education of families about dementia and palliative care, better resource management, and the need to address when palliative care best fits within the dementia process.

Self-care for health professionals

2019 ◽  
pp. 835-842
Keyword(s):  
Palliative Care ◽  
Young Children ◽  
Compassion Fatigue ◽  
Health Professionals ◽  
Self Care ◽  
Care Staff ◽  
Intractable Pain ◽  
Personal Anxiety

This chapter covers theory of palliative care issues associated with caring for people who are dying and the particular stresses involved. Sources of stress are multiple, may be accumulative, and are linked to all areas of an individual’s life. Working with dying people may be stressful, particularly if staff experience personal bereavement and loss. Such work can put staff in touch with personal anxiety about loss and death. Palliative care staff also find it very stressful to deal with patients who experience intractable pain, those who have young children, and those patients who are afraid to die. Symptoms that leave nurses feeling helpless, useless, and impotent are the most stressful to deal with, as is dealing with distressed relatives. The chapter looks at strategies for supporting a workforce involved in the ongoing delivery of palliative care to avoid burnout and compassion fatigue.

Specialist Networks Influence Clinician Willingness to Treat Individuals with Special Needs

2021 ◽  
pp. 238008442110202
Author(s):  
M.A.W.T. Lim ◽  
S.A.C. Liberali ◽  
H. Calache ◽  
P. Parashos ◽  
G.L. Borromeo
Keyword(s):  
Special Needs ◽  
Health Professionals ◽  
Rural Areas ◽  
Dental Service ◽  
Aging Workforce ◽  
The South ◽  
Structured Interviews ◽  
Hub And Spoke ◽  
Barriers To Access ◽  
Patients With Special Needs

Background: The South Australian Dental Service’s Special Needs Network was established to support oral health professionals working within their statewide government-funded dental service to treat patients with special needs. This study aimed to investigate how a structured network relationship with specialists in special needs dentistry influenced the willingness of dentists to treat this group of patients. Methods: Semi-structured interviews were used to explore the views of specialists and dentists involved in the South Australian Dental Service’s Special Needs Network. Inductive thematic analysis identified emerging themes enabling completion of a SWOT (strengths, weaknesses, opportunities, threats) analysis. Results: Dentists felt that a strength of the Network was a greater sense of collegiality, particularly for those working in rural areas. Although the inability to get immediate advice was seen as a weakness, dentists felt a more structured relationship with specialists improved communication pathways and resulted in more timely care. The aging workforce, systemic barriers in the public dental system, such as productivity pressures and infrastructure, and the lack of support from other health professionals were seen as ongoing barriers and threats. Regardless, dentists identified the use of telehealth and visiting specialists as future opportunities. Specialists felt that the Network was a valuable resource but were skeptical about its effectiveness, feeling that a limitation was the ability of dentists to recognize the complexity of cases. Conclusions: Ongoing support from and communication with specialists in special needs dentistry through a structured network improved the perceived ability and willingness of dentists to treat patients with special needs. Knowledge Transfer Statement: This research suggests that providing support to dentists through a hub-and-spoke network that facilitates additional training, professional interaction, and improved communication with specialists in special needs dentistry may help overcome some of the current barriers to access to care experienced by individuals with special needs, particularly those associated with the willingness and capability of clinicians treat them.

scholarly journals Experiences of staff providing specialist palliative care during COVID-19: A multiple qualitative case study.

2021 ◽  
Author(s):  
Andy Bradshaw ◽  
Lesley Dunleavy ◽  
Ian Garner ◽  
Nancy Preston ◽  
Sabrina Bajwah ◽  
...  
Keyword(s):  
Palliative Care ◽  
Moral Distress ◽  
Death And Dying ◽  
Well Being ◽  
Study Data ◽  
Care Staff ◽  
Specialist Palliative Care ◽  
Structured Interviews ◽  
Framework Analysis

Objectives: To explore the experiences of, and impact on, staff working in palliative care during the COVID-19 pandemic. Design: Qualitative multiple case study using semi-structured interviews between November 2020 and April 2021 as part of the CovPall study. Data were analysed using thematic framework analysis. Setting: Organisations providing specialist palliative services in any setting. Participants: Staff working in specialist palliative care, purposefully sampled by the criteria of role, care setting and COVID-19 experience. Main outcome measures: Experiences of working in palliative care during the COVID-19 pandemic. Results: Five cases and 24 participants were recruited (n=12 nurses, 4 clinical managers, 4 doctors, 2 senior managers, 1 healthcare assistant, 1 allied healthcare professional). Central themes demonstrate how infection control constraints prohibited and diluted participants ability to provide care that reflected their core values, resulting in experiences of moral distress. Despite organisational, team, and individual support strategies, continually managing these constraints led to a crescendo effect in which the impacts of moral distress accumulated over time, sometimes leading to burnout. Solidarity with colleagues and making a valued contribution provided moral comfort for some. Conclusions: This study provides a unique insight into why and how healthcare staff have experienced moral distress during the pandemic, and how organisations have responded. Despite their experience of dealing with death and dying, the mental health and well-being of palliative care staff was affected by the pandemic. Organisational, structural, and policy changes are urgently required to mitigate and manage these impacts.

scholarly journals Cultural health literacy: the experiences of Māori in palliative care

2018 ◽  
Vol 25 (4) ◽  
pp. 15-23 ◽  
Author(s):  
Jacquie Kidd ◽  
Stella Black ◽  
Rawiri Blundell ◽  
Tamati Peni
Keyword(s):  
Palliative Care ◽  
New Zealand ◽  
Health Literacy ◽  
Health Information ◽  
Health Professionals ◽  
Health Resources ◽  
Structured Interviews ◽  
Aotearoa New Zealand ◽  
Palliative Care Setting ◽  
Maori Health

Abstract: Health literacy is a concept that is frequently applied to the patient’s ability to find and comprehend health information. However, recent literature has included the skill of the health professional and the accessibility of health resources as important factors in the level of health literacy achieved by individuals and populations. In 2014 a qualitative study undertaken in Aotearoa New Zealand, investigated the context of health literacy for Māori in a palliative care setting (Māori are the indigenous people of Aotearoa New Zealand). The study included the experiences of patients, whānau (families), and health professionals. Method: Individual semi-structured interviews were held with 21 patients, whānau and six key informants: a medical specialist, a service leader involved in developing culturally specific responses to patients, two Māori service managers, and two Māori health team leaders. Focus groups were held with a total of 54 health professionals providing palliative care services. Data analysis: A thematic analysis was undertaken using a general inductive approach. The trustworthiness and reliability of the analysis was supported by sharing analysis of the transcripts among the research team. Member checking or respondent validation was used in seeking confirmation of the interim findings at five hui (meetings) with the research communities involved. Findings: This study found that the shock and grief that attends a life-limiting illness made hearing and processing health information very difficult for patients and whānau. Further, ‘hard conversations’ about moving from active treatment to palliative care were often avoided by health professionals, leaving patients and whānau distressed and confused about their choices and prognosis. Finally, poor cultural health literacy on the part of organisations has likely impacted on late access to or avoidance of palliative care for Māori.

scholarly journals A Canadian-Wide Perspective on the Essential Conditions for Taking a Comprehensive School Health Approach

2020 ◽  
Author(s):  
Kacey C Neely ◽  
Genevieve R. Montemurro ◽  
Kate E. Storey
Keyword(s):  
School Health ◽  
Evidence Base ◽  
Comprehensive School ◽  
Successful Implementation ◽  
Evaluation Tool ◽  
Structured Interviews ◽  
Immediate Feedback ◽  
Essential Condition ◽  
School Communities ◽  
Comprehensive School Health

Abstract Background: The primary purpose of this research was to confirm whether the essential conditions for taking a Comprehensive School Health (CSH) approach held true in other contexts across Canada. The secondary purpose was to determine if the development of an evaluative tool or resource is needed to assess the implementation of the essential conditions. Methods: Data were generated through individual semi-structured interviews (n = 38) and small focus groups (n = 3) with 45 participants across Canada involved in implementing policies or programs which take a CSH approach. Interviews were subjected to content analysis. Results: There was positive support for the essential conditions and results indicated the essential conditions are relevant across Canada. Findings revealed the necessity for a new essential condition that reflected support and leadership from the school district and/or provincial/territorial governing bodies. Modifications to the description of each of the essential conditions were also suggested to provide clarity. Results also indicated that an evaluative tool that was concise, meaningful, and provided immediate feedback would be useful to school communities to establish readiness, assess, and improve ongoing implementation of CSH approaches. Conclusions: This research contributes to the evidence-base of CSH by providing school communities across Canada with a set of refined and understandable essential conditions that support successful implementation. Further, the development of an evaluation tool will support school health champions, researchers, and policymakers in the optimization and implementation of policies or programs which take a CSH approach, ultimately supporting healthier school communities across the country.

Informatics and Literature Search

2015 ◽  
Author(s):  
Jennifer J. Tieman ◽  
David C. Currow
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Domain Knowledge ◽  
Literature Search ◽  
Evidence Base ◽  
Practice Research ◽  
Clinical Knowledge ◽  
Research And Education ◽  
The Individual

Health information technology is changing how health professionals engage with and use knowledge and how health systems organize care. Tools and resources can facilitate access to evidence and enable its application in practice improving outcomes for the individual patient and for the health-care system. However, the quality of these applications relies on the quality and currency of the domain knowledge that is embedded within them and distributed through them. Therefore being able to identify and retrieve palliative care’s evidence base is more critical than ever. Given the complexity of timely, efficient, and effective retrieval of needed knowledge, new approaches are needed to manage the expanding and diffuse knowledge base for palliative care. Such strategies include developing online repositories of clinical knowledge to ensure immediate access and creating search solutions that shortcut access to literature and evidence to support practice, research, and education.

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