scholarly journals Whole Person Team Care

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Glen Komatsu ◽  
Denise Hess
Keyword(s):  
Palliative Care ◽  
Identity Formation ◽  
Mindfulness Meditation ◽  
Meaning Making ◽  
Interdisciplinary Team ◽  
Well Being ◽  
Interdisciplinary Teams ◽  
Self Awareness ◽  
Palliative Care Teams ◽  
Whole Person

In the rapidly changing environment of 21st century healthcare, effective interdisciplinary team-based care is a key ingredient in providing whole person care across the continuum. Interdisciplinary teams face significant issues and challenges in providing whole person care given the boundaries that exist between various healthcare disciplines. Systemic institutional barriers and hierarchies commonly work against team communication, cooperation, and collaboration. These work environments contribute to work-related stress, staff turnover, inefficient, lower quality care, burnout, and compassion fatigue. Ultimately team environments that do not foster team member well-being are unlikely to find success in creating environments that foster whole person care. Given these realities, teams who hope to provide whole-person care need strategies for creating and sustaining a team environment of self-awareness, self-compassion, mindfulness and non-judgmental presence.This session will present the outcomes of three innovative approaches to interdisciplinary care team flourishing through case study analysis of hospital-based palliative care teams, and adult/pediatric hospice teams. The first intervention illustrates a process for developing and implementing a team retreat experience. Combining elements of team building, experiential learning and discussion of assigned readings, palliative care and hospice teams exhibit increased team trust, respect and communication across discipline boundaries. The second intervention demonstrates positive meaning-making through the use of a “spiritual narrative.” Through sustained reflection on a guiding metaphor, “spiritual narratives” enhance team identity formation, function, and sustainability. The third intervention outlines a model for group mindfulness meditation. Through regular practice of mindfulness meditation as an integrated component of the work day, team members sought to increase their self-awareness, presence, attunement and compassion in clinical interactions. Attendees of this workshop will be inspired and equipped to with new ways to enrich interdisciplinary team flourishing while providing excellent whole person care.

scholarly journals Narrative and Palliative Care Team Identity Formation

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Denise Hess
Keyword(s):  
Palliative Care ◽  
Identity Formation ◽  
Meaning Making ◽  
Quality Care ◽  
Palliative Care Team ◽  
Care Team ◽  
Spiritual Needs ◽  
Team Identity ◽  
Team Members ◽  
Palliative Care Teams

Palliative care is whole person care that attends to the physical, psychosocial, and spiritual needs of persons with a serious or life-limiting illness. This care is provided by a team of clinicians from several disciplines including physicians, nurses, social workers, and chaplains. The palliative care team functions as a dynamic system whose ability to provide quality care is dependent upon the ability of the team members to form and maintain an ongoing collaborative alliance. This alliance requires that team members maintain dual commitments to both the care receivers and to their fellow team members. Just as persons with illness express the human propensity toward meaning making in the face of suffering, so palliative care teams thrive when they are supported in reflective processes that enhance their ability to find meaning in their work. Creation of and attention to team narratives and their role in team identity formation can enhance team members’ flourishing by placing team identity in the context of a larger story. Narratives of rescuing and fixing foster a sense of control and expertise while narratives of containing and healing nurture attention to mindful presence and human-to-human encounter.

scholarly journals Training interprofessional faculty in humanism and professionalism: a qualitative analysis of what is most important

2022 ◽  
Vol 9 (1) ◽  
pp. 46-47
Author(s):  
Elizabeth A Rider ◽  
Deborah D. Navedo ◽  
William T. Branch, Jr.
Keyword(s):  
Identity Formation ◽  
Learning Environments ◽  
Interprofessional Education ◽  
Well Being ◽  
Care Quality ◽  
Self Awareness ◽  
Use Of Self ◽  
Important Thing ◽  
Relational Capacities ◽  
The Impact

Introduction: The capacity of healthcare professionals to work collaboratively influences faculty and trainees’ professional identity formation, well-being, and care quality. Part of a multi-institutional project*, we created the Faculty Fellowship for Leaders in Humanistic Interprofessional Education at Boston Children’s Hospital/ Harvard Medical School. We aimed to foster trusting relationships, reflective abilities, collaboration skills, and work together to promote humanistic values within learning environments. Objective: To examine the impact of the faculty fellowship from participants’ reports of “the most important thing learned”. Methods: We studied participants’ reflections after each of 16 1½ hour fellowship sessions. Curriculum content included: highly functioning teams, advanced team formation, diversity/inclusion, values, wellbeing/renewal/burnout, appreciative inquiry, narrative reflection, and others. Responses to “What was the most important thing you learned?” were analyzed qualitatively using a positivistic deductive approach. Results: Participants completed 136 reflections over 16 sessions–77% response rate (136/176). Cohort was 91% female; mean age 52.6 (range 32-65); mean years since completion of highest degree 21.4; 64% held doctorates, 36% master’s degrees. 46% were physicians, 27% nurses, 18% social workers, 9% psychologists. 27% participated previously in a learning experience focusing on interprofessional education, collaboration or practice. Most important learning included: Relational capacities/ Use of self in relationships 96/131 (73%); Attention to values 46/131 (35%); Reflection/ Self-awareness 44/131 (34%); Fostering humanistic learning environments 21/131 (16%). Discussion: Results revealed the importance of enhancing relational capacities and use of self in relationships including handling emotions; attention to values; reflection/self-awareness and recognition of assumptions; and fostering humanistic learning environments. These topics should receive more emphasis in interprofessional faculty development programs and may help identify teaching priorities. *Supported in part by a multi-institutional grant from the Josiah Macy, Jr. Foundation (Dr. Branch as PI; Dr. Rider as site PI).

Mental healthcare and palliative care: barriers

2020 ◽  
pp. bmjspcare-2019-001986 ◽  
Author(s):  
Kelly O'Malley ◽  
Laura Blakley ◽  
Katherine Ramos ◽  
Nicole Torrence ◽  
Zachary Sager
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
Psychological Symptoms ◽  
Mental Healthcare ◽  
Well Being ◽  
Psychological Needs ◽  
Treatment Team ◽  
Advanced Illness ◽  
Palliative Care Teams ◽  
The Usa

ContextPsychological symptoms are common among palliative care patients with advanced illness, and their effect on quality of life can be as significant as physical illness. The demand to address these issues in palliative care is evident, yet barriers exist to adequately meet patients’ psychological needs.ObjectivesThis article provides an overview of mental health issues encountered in palliative care, highlights the ways psychologists and psychiatrists care for these issues, describes current approaches to mental health services in palliative care, and reviews barriers and facilitators to psychology and psychiatry services in palliative care, along with recommendations to overcome barriers.ResultsPatients in palliative care can present with specific mental health concerns that may exceed palliative care teams’ available resources. Palliative care teams in the USA typically do not include psychologists or psychiatrists, but in palliative care teams where psychologists and psychiatrists are core members of the treatment team, patient well-being is improved.ConclusionPsychologists and psychiatrists can help meet the complex mental health needs of palliative care patients, reduce demands on treatment teams to meet these needs and are interested in doing so; however, barriers to providing this care exist. The focus on integrated care teams, changing attitudes about mental health, and increasing interest and training opportunities for psychologists and psychiatrists to be involved in palliative care, may help facilitate the integration of psychology and psychiatry into palliative care teams.

scholarly journals The Integrative Psychiatry Curriculum: Development of an Innovative Model

2019 ◽  
Vol 8 ◽  
pp. 216495611984711
Author(s):  
Noshene Ranjbar ◽  
Mari Ricker ◽  
Amelia Villagomez
Keyword(s):  
Online Courses ◽  
Training Programs ◽  
Treatment Options ◽  
Well Being ◽  
Evidence Base ◽  
Self Awareness ◽  
Group Setting ◽  
Whole Person ◽  
Treatment Plans ◽  
Integrative Psychiatry

The Integrative Psychiatry Curriculum (IPC) was developed to train psychiatry residents and fellows to apply an Integrative Medicine (IM) approach for patients presenting with psychiatric disorders. Launched in 2015, IPC includes interactive online courses, in-person experiential sessions, and a clinical component with supervision. Twenty-one residents and fellows have completed the curriculum. The purpose of the IPC is 2-fold: to enhance patient wellness through training residents and fellows in evidence-based whole-person care and to improve physician well-being through enhanced stress management and self-awareness utilizing the practice of mind–body skills within a supportive small group setting. Course participants are trained in a broad range of prevention and treatment options and learn about their evidence base; they then practice incorporating IM into diagnosis and treatment plans through supervised clinical experience. This article describes the development of IPC and its elements. Efforts are underway to further develop and standardize the offerings and increase the portability of the course, making it easier for Psychiatry training programs with limited faculty expertise in IM to provide the curriculum for residents and fellows. To reach the goal of disseminating such a curriculum for integrative psychiatry, further funding and collaboration with multiple residency training programs is needed.

scholarly journals Patients’ priorities in a reminiscence and legacy intervention in palliative care

2019 ◽  
Vol 13 ◽  
pp. 263235241989262
Author(s):  
Michaela Hesse ◽  
Simon Forstmeier ◽  
Gülay Ates ◽  
Lukas Radbruch
Keyword(s):  
Palliative Care ◽  
Well Being ◽  
Life Review ◽  
University Hospital ◽  
Self Awareness ◽  
Growing Up ◽  
Philosophy Of Life ◽  
Dignity Therapy ◽  
And Coping ◽  
The University

Background: Reminiscence is used in a range of different interventions in palliative care, for example, Dignity Therapy or Life Review. However, literature has focused mainly on the methodology, and little has been published on patients’ priorities and primary concerns. Objective: This study looks at themes emerging in a reminiscence intervention with patients confronted with a life-limiting disease. Interviews were audiotaped and transcribed verbatim. Transcripts were analysed using thematic analysis. Setting/subjects: Seventeen patients who were receiving palliative care at the University Hospital Bonn participated in interviews reviewing parts or phases of their lives. Results: Patients expressed satisfaction and a sense of well-being with the intervention. Major themes emerging in the interviews were the factors involved in the development and expression of personality, such as character-forming influences, self-image, self-awareness, and philosophy of life. Talking about personality was entangled with influences from growing up, qualification/job, partner/spouse, children, resources, twists of fate/crossroads, and coping. Conclusion: The topics emerging from the interviews differed from the scope of guiding questions in common reminiscence methods like Life Review or Dignity Therapy. The underlying motivation of patients seemed to be the search for identity and continuity in one’s life.

Establishing Relationships With Specialty Palliative Care for More Complex Patient Needs

2020 ◽  
pp. 67-75
Author(s):  
Kate Schueller ◽  
Joseph D. Rotella
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Palliative Care ◽  
Quality Improvement ◽  
Palliative Care Team ◽  
Patient Needs ◽  
Improve Quality ◽  
Palliative Care Teams ◽  
Whole Person

Interdisciplinary palliative care teams can improve quality of life by addressing the needs and experience of the whole person with chronic kidney disease, including physical, psychological, social, spiritual, cultural, end-of-life, ethical, and practical concerns. Nephrology teams can develop the essential skills to provide primary palliative care for uncomplicated problems, but consultation with a specialty palliative care team is warranted for more severe, complex, or refractory problems. Although specialty palliative care can be delivered in any care setting, it may be a scarce resource outside of a hospital or hospice. Nephrology teams should identify all the specialty palliative care resources available in their community and consider engaging palliative care experts not only in patient care but also in advisory, educational, and quality improvement activities.

How Leaders, Teams and Organisations can prevent Burnout and build Resilience: a thematic analysis’

2020 ◽  
pp. bmjspcare-2020-002774
Author(s):  
Mervyn Yong Hwang Koh ◽  
Hwee Sing Khoo ◽  
Marysol Dalisay Gallardo ◽  
Allyn Hum
Keyword(s):  
Palliative Care ◽  
Social Workers ◽  
Thematic Analysis ◽  
Well Being ◽  
Analysis Approach ◽  
Open Communication ◽  
Building Resilience ◽  
Palliative Care Teams ◽  
The Mean ◽  
Adequate Staffing

ContentBurnout occurs commonly in palliative care. Building resilience helps to mitigate the effects of burnout. Little is known about the importance of leaders, teams and organisations in preventing burnout and promoting resilience in palliative care.ObjectivesWe studied palliative care clinicians with more than a decade’s experience looking into their experiences on the role leaders, teams and organisations play in burnout and resilience.Patients and methodsThis is a thematic analysis focusing on how leaders, teams and organisations influence burnout and resilience. 18 palliative care clinicians—5 doctors, 10 nurses and 3 social workers—who worked in various palliative care settings (hospital, home hospice and inpatient hospice) were interviewed using semistructured questionnaires. The mean age of the interviewees was 52 years old, and the mean number of years practising palliative care was 15.7 years (ranging from 10 to 25 years). The interviews were recorded verbatim and were transcribed and analysed using a thematic analysis approach.ResultsThe following themes featured prominently in our study. For leaders: being supportive, caring and compassionate, being a good communicator and showing protective leadership. With teams: being like-minded, caring for the team, sharing the burden and growing together. For organisations: having a strong commitment to palliative care, supporting staff welfare and development, open communication, adequate staffing and organisational activities promoting staff well-being were described as protective against burnout and promoting resilience.ConclusionLeaders, teams and organisations play an important role in helping palliative care teams to reduce burnout and promote resilience.

scholarly journals Palliative Care Consult for Clinician Distress Through the Philosophical Lenses of Gender Norms and Phenomenology

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 245-245
Author(s):  
Anessa Foxwell ◽  
Salimah Meghani ◽  
Connie Ulrich
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Gender Norms ◽  
Well Being ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Social Construct ◽  
The Social ◽  
Palliative Care Teams ◽  
Seriously Ill

Abstract The National Academy of Medicine has raised significant concerns on clinician health and well-being as many experiencing burnout, post-traumatic stress, and depression. Indeed, clinicians experience a range of human emotions when caring for older adults with severe, life-limiting illnesses. These emotions may manifest in multiple ways and from various sources. Uncertain of how to attend to such distress, clinicians may consult a trusted resource, including the palliative care team. Palliative care specialists are trained to support the complexities and needs of patients and families; increasingly, however, palliative care consults are rooted in clinician distress. This session uses clinical case examples to explore the palliative care consult for distressed clinicians from two different philosophical perspectives: (1) phenomenology and (2) the social construct of gender norms. A phenomenological lens respects the unique, subjective lived experience of each individual in their day-to-day interactions with patients, families, and health care systems. Therefore, when caring for seriously ill older adults, clinicians may bring their own subjective experiences to the patient encounter and react differently to ethical dilemmas and conflicts that arise. The social construct of gender norms asks us to examine clinician distress from a different perspective. Here, the postmodern rejection of gender binarism allows clinicians to experience a spectrum of emotions and distress regardless of gender. Exploration through clinical cases will highlight the unique, varied experience of clinician distress and offer opportunities for future research into the role of palliative care teams in supporting distressed clinicians who care for seriously ill older adults.

scholarly journals Coping Through COVID-19: A Mixed Method Approach to Understand How Palliative Care Teams Managed the COVID-19 Pandemic

2021 ◽  
pp. 104990912110456
Author(s):  
Kayla D. Finuf ◽  
Santiago Lopez ◽  
Maria T. Carney
Keyword(s):  
New York ◽  
Palliative Care ◽  
Physical Health ◽  
Coping Strategies ◽  
New York State ◽  
Supervisor Support ◽  
Well Being ◽  
Subjective Well Being ◽  
Positive Effects ◽  
Palliative Care Teams

Objective: While previous work documented a substantial increase in patient mortality consultations and workload for palliative teams, little is known about how these team members managed their mental and physical health during the COVID-19 pandemic. We investigated how job resources (coworker and supervisor support) and personal resources (coping strategies) reduced perceptions of burnout and increased perceptions of well-being. Method: An anonymous electronic survey was sent to all members ( N = 64) of the palliative medical team among 14 hospitals of a New York State health system. Data were collected between September 2020 to October 2020. Measures included validated scales for burnout (Oldenburg Burnout Inventory), coping strategies (Cybernetic Coping Scale), subjective well-being (BBC Subjective Well-being scale), and coworker/supervisor support (7 items from Yang et al). Results: Results indicated devaluation coping tactics were used to reduce perceptions of burnout and to increase perceptions of physical health. Higher burnout was identified when using avoidance coping techniques. Furthermore, coworkers and supervisor(s) support significantly reduced disengagement when compared to coworker support alone. Conclusion: COVID-19 exacerbated burnout experienced by palliative care teams, yet the use of coping behaviors (devaluation/avoidance) and external resources (coworker and supervisor support) utilized by these teams were found to have positive effects. Further research should investigate these antagonizing factors to help preventing and addressing burn out during times of crises and in the everyday of palliative care teams.

Interdisciplinary Palliative Care Teams

2019 ◽  
pp. 89-97
Author(s):  
Polly Mazanec ◽  
Rebekah Reimer ◽  
Jessica Bullington ◽  
Patrick J. Coyne ◽  
Herman Harris ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Delivery ◽  
Medical Center ◽  
Academic Medical Center ◽  
Interdisciplinary Team ◽  
Palliative Care Team ◽  
Care Team ◽  
Patient Centered ◽  
Team Members ◽  
Palliative Care Teams

This chapter defines the composition and roles of interdisciplinary team members on a palliative care team. The team has the responsibility to deliver patient-centered, family-focused care based on the recommendations from the National Consensus Project Guidelines for Quality Palliative Care. Within this chapter, interdisciplinary team members from an academic medical center discuss their respective roles on the team and describe how these roles supported a patient and family case study. The chapter provides an overview of the four most common models of palliative care delivery: inpatient consult teams, with or without a palliative care unit; ambulatory palliative care teams; community-based palliative care teams; and hospice teams. An introduction to essential considerations in the development of a palliative care team and the important components for maintaining a healthy, functional team are described.

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