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Implementation of the integrated palliative care outcome scale in acute care settings - a feasibility study

Lind, Susanne ; Sandberg, J. ; Brytting, T. ; Fürst, C. J. LU and Wallin, L. (2018) In Palliative & Supportive Care 16(6). p.698-705
Abstract

OBJECTIVE: Although hospitals have been described as inadequate place for end-of-life care, many deaths still occur in hospital settings. Although patient-reported outcome measures have shown positive effects for patients in need of palliative care, little is known about how to implement them. We aimed to explore the feasibility of a pilot version of an implementation strategy for the Integrated Palliative care Outcome Scale (IPOS) in acute care settings. METHOD: A strategy, including information, training, and facilitation to support the use of IPOS, was developed and carried out at three acute care units. For an even broader understanding of the strategy, it was also tested at a palliative care unit. A process evaluation was conducted... (More)

OBJECTIVE: Although hospitals have been described as inadequate place for end-of-life care, many deaths still occur in hospital settings. Although patient-reported outcome measures have shown positive effects for patients in need of palliative care, little is known about how to implement them. We aimed to explore the feasibility of a pilot version of an implementation strategy for the Integrated Palliative care Outcome Scale (IPOS) in acute care settings. METHOD: A strategy, including information, training, and facilitation to support the use of IPOS, was developed and carried out at three acute care units. For an even broader understanding of the strategy, it was also tested at a palliative care unit. A process evaluation was conducted including collecting quantitative data and performing interviews with healthcare professionals.ResultFactors related to the design and performance of the strategy and the context contributed to the results. The prevalence of completed IPOS in the patient's records varied from 6% to 44% in the acute care settings. At the palliative care unit, the prevalence in the inpatient unit was 53% and the specialized home care team 35%. The qualitative results showed opposing perspectives concerning the training provided: Related to everyday work at the acute care units and Nothing in it for us at the palliative care unit. In the acute care settings, A need for an improved culture regarding palliative care was identified. A context characterized by A constantly increasing workload, a feeling of Constantly on-going changes, and a feeling of Change fatigue were found at all units. Furthermore, the internal facilitators and the nurse managers' involvement in the implementation differed between the units.Significance of the resultsThe feasibility of the strategy in our study is considered to be questionable and the components need to be further explored to enhance the impact of the strategy and thereby improve the use of IPOS.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute care settings, facilitation, Implementation, integrated palliative care outcome scale, palliative care
in
Palliative & Supportive Care
volume
16
issue
6
pages
8 pages
publisher
Cambridge University Press
external identifiers
  • pmid:29352836
  • scopus:85059435888
ISSN
1478-9515
DOI
10.1017/S1478951517001158
language
English
LU publication?
yes
id
5c7d1629-67b0-40e7-9305-e014cbb03b44
date added to LUP
2019-01-16 08:48:42
date last changed
2020-02-26 07:12:53
@article{5c7d1629-67b0-40e7-9305-e014cbb03b44,
  abstract     = {<p>OBJECTIVE: Although hospitals have been described as inadequate place for end-of-life care, many deaths still occur in hospital settings. Although patient-reported outcome measures have shown positive effects for patients in need of palliative care, little is known about how to implement them. We aimed to explore the feasibility of a pilot version of an implementation strategy for the Integrated Palliative care Outcome Scale (IPOS) in acute care settings. METHOD: A strategy, including information, training, and facilitation to support the use of IPOS, was developed and carried out at three acute care units. For an even broader understanding of the strategy, it was also tested at a palliative care unit. A process evaluation was conducted including collecting quantitative data and performing interviews with healthcare professionals.ResultFactors related to the design and performance of the strategy and the context contributed to the results. The prevalence of completed IPOS in the patient's records varied from 6% to 44% in the acute care settings. At the palliative care unit, the prevalence in the inpatient unit was 53% and the specialized home care team 35%. The qualitative results showed opposing perspectives concerning the training provided: Related to everyday work at the acute care units and Nothing in it for us at the palliative care unit. In the acute care settings, A need for an improved culture regarding palliative care was identified. A context characterized by A constantly increasing workload, a feeling of Constantly on-going changes, and a feeling of Change fatigue were found at all units. Furthermore, the internal facilitators and the nurse managers' involvement in the implementation differed between the units.Significance of the resultsThe feasibility of the strategy in our study is considered to be questionable and the components need to be further explored to enhance the impact of the strategy and thereby improve the use of IPOS.</p>},
  author       = {Lind, Susanne and Sandberg, J. and Brytting, T. and Fürst, C. J. and Wallin, L.},
  issn         = {1478-9515},
  language     = {eng},
  number       = {6},
  pages        = {698--705},
  publisher    = {Cambridge University Press},
  series       = {Palliative & Supportive Care},
  title        = {Implementation of the integrated palliative care outcome scale in acute care settings - a feasibility study},
  url          = {http://dx.doi.org/10.1017/S1478951517001158},
  doi          = {10.1017/S1478951517001158},
  volume       = {16},
  year         = {2018},
}