Background: The number of people with multiple chronic conditions receiving primary care services is growing. To deal with their increasingly complex health care demands, professionals from different disciplines need to collaborate. Interprofessional team (IPT) meetings are becoming more popular. Several studies describe important factors related to conducting IPT meetings, mostly from a professional perspective. However, in the light of patient-centeredness, it is valuable to also explore the patients’ perspective. Objective: The aim was to explore the patients’ perspectives regarding IPT meetings in primary care. Methods: A qualitative study with a focus group design was conducted in the Netherlands. Two focus group meetings took place, for which the same patients were invited. The participants, chronically ill patients with experience on interprofessional collaboration, were recruited through the regional patient association. Participants discussed viewpoints, expectations, and concerns regarding IPT meetings in two rounds, using a focus group protocol and selected video-taped vignettes of team meetings. The first meeting focused on conceptualization and identification of themes related to IPT meetings that are important to patients. The second meeting aimed to gain more in-depth knowledge and understanding of the priorities. Discussions were audio-taped and transcribed verbatim, and analyzed by means of content analysis. Results: The focus group meetings included seven patients. Findings were divided into six key categories, capturing the factors that patients found important regarding IPT meetings: (1) putting the patient at the center, (2) opportunities for patients to participate, (3) appropriate team composition, (4) structured approach, (5) respectful communication, and (6) informing the patient about meeting outcomes. Conclusions: Patients identified different elements regarding IPT meetings that are important from their perspective. They emphasized the right of patients or their representatives to take part in IPT meetings. Results of this study can be used to develop tools and programs to improve interprofessional collaboration.
Intention of healthcare providers to use video-communication in terminal care: a cross-sectional study. Richard M. H. Evering, Marloes G. Postel, Harmieke van Os-Medendorp, Marloes Bults and Marjolein E. M. den Ouden BMC Palliative Care volume 21, Article number: 213 (2022) Cite this articleAbstractBackgroundInterdisciplinary collaboration between healthcare providers with regard to consultation, transfer and advice in terminal care is both important and challenging. The use of video communication in terminal care is low while in first-line healthcare it has the potential to improve quality of care, as it allows healthcare providers to assess the clinical situation in real time and determine collectively what care is needed. The aim of the present study is to explore the intention to use video communication by healthcare providers in interprofessional terminal care and predictors herein.MethodsIn this cross-sectional study, an online survey was used to explore the intention to use video communication. The survey was sent to first-line healthcare providers involved in terminal care (at home, in hospices and/ or nursing homes) and consisted of 39 questions regarding demographics, experience with video communication and constructs of intention to use (i.e. Outcome expectancy, Effort expectancy, Attitude, Social influence, Facilitating conditions, Anxiety, Self-efficacy and Personal innovativeness) based on the Unified Theory of Acceptance and Use of Technology and Diffusion of Innovation Theory. Descriptive statistics were used to analyze demographics and experiences with video communication. A multiple linear regression analysis was performed to give insight in the intention to use video communication and predictors herein.Results90 respondents were included in the analysis.65 (72%) respondents had experience with video communication within their profession, although only 15 respondents (17%) used it in terminal care. In general, healthcare providers intended to use video communication in terminal care (Mean (M) = 3.6; Standard Deviation (SD) = .88). The regression model was significant and explained 44% of the variance in intention to use video communication, with ‘Outcome expectancy’ and ‘Social influence’ as significant predictors.ConclusionsHealthcare providers have in general the intention to use video communication in interprofessional terminal care. However, their actual use in terminal care is low. ‘Outcome expectancy’ and ‘Social influence’ seem to be important predictors for intention to use video communication. This implicates the importance of informing healthcare providers, and their colleagues and significant others, about the usefulness and efficiency of video communication.
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OBJECTIVES: To improve transmural palliative care for acutely admitted older patients, the PalliSupport transmural care pathway was developed. Implementation of this care pathway was challenging. The aim of this study was to improve understanding why the implementation partly failed.DESIGN: A qualitative process evaluation study.SETTING/PARTICIPANTS: 17 professionals who were involved in the PalliSupport program were interviewed.METHODS: Online semi-structured interviews. Thematic analysis to create themes according to the implementation framework of Grol & Wensing.RESULTS: From this study, themes within four levels of implementation emerged: 1) The innovation: challenges in current palliative care, the setting of the pathway and boost for improvement; 2) Individual professional: feeling (un)involved and motivation; 3) Organizational level: project management; 4) Political and economic level: project plan and evaluation.CONCLUSION AND IMPLICATIONS: We learned that the challenges involved in implementing a transmural care pathway in palliative care should not be underestimated. For successful implementation, we emphasize the importance of creating a program that fits the complexity of transmural palliative care. We suggest starting on a small scale and invest in project management. This could help to involve all stakeholders and anticipate current challenges in palliative care. To increase acceptance, create one care pathway that can start and be used in all care settings. Make sure that there is sufficient flexibility in time and room to adjust the project plan, so that a second pilot study can possibly be performed, and choose a scientific evaluation with both rigor and practical usefulness to evaluate effectiveness.
In de palliatieve terminale zorg is men nog erg terughoudend in de toepassing van telehealth technologie, terwijl voorgaande studies wel de potentiele meerwaarde ervan hebben aangetoond. In deze postdoc aanvraag zal daarom nader onderzoek worden gedaan naar de acceptatie van telehealth in de palliatieve terminale zorg. Het doel van het onderzoek is inzichtelijk maken hoe telehealth ingezet zou moeten worden in de palliatieve terminale zorg opdat het van meerwaarde is in het ondersteunen van; 1) de uitwisseling van informatie tussen zorgvragers en zorgverleners, en 2) de sociale interactie van zorgvragers met familie en naasten. De thematiek van het onderzoek sluit aan bij de onderzoekslijn Technology in Society van het lectoraat Technology, Health & Care. Het lectoraat opereert vanuit de pijler Health & Wellbeing dat onderdeel vormt van de corporate onderzoeksagenda van Saxion getiteld Living Technology'. De postdoc zal onder supervisie van de lector het onderzoek nader gaan uitwerken en uitvoeren. Daarbij zal ook nauwe samenwerking worden gezocht met studenten en de praktijk. Tevens zal de postdoc onderdeel uitmaken van een onderwijsteam opdat vervlechting van onderzoek en onderwijs goed tot stand gaat komen. In grote lijnen zal het onderzoek bestaan uit een literatuurstudie en een studie in de praktijk naar het gebruik en ervaringen van telehealth in de palliatieve terminale zorg. Vervolgens zal nader onderzoek zich richten op het ontwerp van een testopstelling voor de toepassing van telehealth in de praktijk van palliatieve terminale zorg. De postdoc zal zorgdragen dat studentopdrachten worden uitgezet bij diverse opleidingen opdat studenten kennis maken met het doen van onderzoek, en dat inspirerende colleges worden ontwikkeld, ingebed en verzorgd in diverse curricula. Daar waar mogelijk gaan studenten en docenten van verschillende opleidingen samenwerken om de gewenste interdisciplinariteit vorm te geven. Tot slot zal de postdoc in het kader van professionalisering zorgdragen voor kennisoverdracht naar docenten.
