Abstract
ObjectiveTo identify actions required to strengthen the delivery of person and family centred hospital-based palliative care so that it addressed the domains of care identified as important for inpatients with palliative care needs and their families.MethodsA codesign study involving a workshop with palliative care and acute hospital policy, consumer and clinical representatives in Australia. A modified nominal group process generated a series of actions, which were thematically analysed and refined, before being circulated to participants to gain consensus.ResultsMore than half (n=30, 58%) of the invited representatives (n=52) participated in the codesign process. Nine actions were identified as required to strengthen inpatient palliative care provision being: (a) evidence-informed practice and national benchmarking; (b) funding reforms; (c) securing executive level support; (d) mandatory clinical and ancillary education; (e) fostering greater community awareness; (f) policy reviews of care of the dying; (g) better integration of advance care planning; (h) strengthen nursing leadership; and (i) develop communities of practice for improving palliative care.ConclusionsChanges to policy, practice, education and further research are required to optimise palliative care within hospital settings, in accordance with the domains inpatients with palliative care needs and their families consider to be important. Achieving these changes will require a whole of sector approach and significant national and jurisdictional leadership.
Funder
Australian Government Research Training Program Scholarship
Subject
Medical–Surgical Nursing,Oncology (nursing),General Medicine,Medicine (miscellaneous)
Reference41 articles.
1. Cherny NI , Fallon M , Kaasa S , et al . Oxford textbook of palliative medicine. Oxford,USA: University Press, 2015.
2. World Health Organization,Geneva . The top 10 causes of death, 2018. Available: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death [Accessed 22 Apr 2020].
3. Lynn J , Adamson DM . Living well at the end of life. adapting health care to serious chronic illness in old age. United States: RAND Corporation, 2003.
4. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report
5. Dying at home or in the hospital? an observational study in German general practice;Gágyor;Eur J Gen Pract,2016