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Emergency department staff priorities for improving palliative care provision for older people: a qualitative study

journal contribution
posted on 2023-06-09, 06:11 authored by Rebecca J Wright, Karen LowtonKaren Lowton, Robert Glenn, Corita R Grudzen, Patricia Grocott
Background: Emergency department–based palliative care services are increasing, but research to develop these services rarely includes input from emergency clinicians, jeopardizing the effectiveness of subsequent palliative care interventions. Aim: To collaboratively identify with emergency clinicians’ improvement priorities for emergency department–based palliative care for older people. Design: This was one component of an experience-based co-design project, conducted using semi-structured interviews and feedback sessions. Setting/participants: In-depth interviews with 15 emergency clinicians (nurses and doctors) at a large teaching hospital emergency department in the United Kingdom exploring experiences of palliative care delivery for older people. A thematic analysis identified core challenges that were presented to 64 clinicians over five feedback sessions, validating interview findings, and identifying shared priorities for improving palliative care delivery. Results: Eight challenges emerged: patient age; access to information; communication with patients, family members, and clinicians; understanding of palliative care; role uncertainty; complex systems and processes; time constraints; and limited training and education. Through feedback sessions, clinicians selected four challenges as improvement priorities: time constraints; communication and information; systems and processes; and understanding of palliative care. As resulting improvement plans evolved, “training and education” replaced “time constraints” as a priority. Conclusion: Clinician priorities for improving emergency department–based palliative care were identified through collaborative, iterative processes. Though generally aware of older palliative patients’ needs, clinicians struggled to provide high-quality care due to a range of complex factors. Further research should identify whether priorities are shared across other emergency departments, and develop, implement, and evaluate strategies developed by clinicians.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Palliative Medicine

ISSN

0269-2163

Publisher

SAGE Publications

Issue

2

Volume

32

Page range

417-425

Department affiliated with

  • Sociology and Criminology Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2017-05-08

First Open Access (FOA) Date

2017-05-12

First Compliant Deposit (FCD) Date

2017-05-08

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