Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway
Abstract Background Caring for people with palliative care needs in their homes requires close collaboration within and between primary and hospital care. However, such close collaboration is often lacking. Transitions of care are potentially unsafe and distressing points in a patient trajectory. Fe...
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BMC
2022-03-01
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Series: | BMC Health Services Research |
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Online Access: | https://doi.org/10.1186/s12913-022-07713-z |
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author | May-Lill Johansen Bente Ervik |
author_facet | May-Lill Johansen Bente Ervik |
author_sort | May-Lill Johansen |
collection | DOAJ |
description | Abstract Background Caring for people with palliative care needs in their homes requires close collaboration within and between primary and hospital care. However, such close collaboration is often lacking. Transitions of care are potentially unsafe and distressing points in a patient trajectory. Few studies have explored the experiences of healthcare professionals in the community who receive patients from hospital care and provide them with palliative care at home. Objective To explore how rural health professionals experience local and regional collaboration on patients in need of palliative care. Methods This was a qualitative focus group and interview study in rural Northern Norway involving 52 primary care health professionals including district nurses, general practitioners, oncology nurses, physiotherapists, and occupational therapists. Five uni-professional focus group discussions were followed by five interprofessional discussions and six individual interviews. Transcripts were analysed thematically. Results “Talking together” was perceived as the optimal form of collaboration, both within primary care and with specialists. Nurses and GPs had similar perceptions of their worst-case scenario in primary palliative care: the sudden arrival after working hours of a sick patient about whom they lacked information. These situations could be the result of a short notice transfer from secondary care or an emergency presentation after a crisis in patient management locally, the latter often resulting in a hospital admission. Participants missed timely and detailed discharge letters and in complex cases a telephone call or conference. Locally, co-location was perceived as advantageous for crucial communication, mutual support, and knowledge about each other’s competencies and work schedule. Because local health professionals belonged to different units within the primary health care organisation, in some places they had limited knowledge about each other’s roles and skill sets. Conclusions Lack of communication, both locally and between specialist and primary care, was a key factor in the worst-case patient scenarios for GPs and nurses working in primary palliative care in rural Northern Norway. Co-location of primary care professionals promoted local collaboration and should be encouraged. Hospital discharge planning should involve the receiving primary care professionals. |
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format | Article |
id | doaj.art-f516e5d36e0b4a2aa6f39cb4d0e63574 |
institution | Directory Open Access Journal |
issn | 1472-6963 |
language | English |
last_indexed | 2024-12-12T14:34:43Z |
publishDate | 2022-03-01 |
publisher | BMC |
record_format | Article |
series | BMC Health Services Research |
spelling | doaj.art-f516e5d36e0b4a2aa6f39cb4d0e635742022-12-22T00:21:24ZengBMCBMC Health Services Research1472-69632022-03-012211910.1186/s12913-022-07713-zTalking together in rural palliative care: a qualitative study of interprofessional collaboration in NorwayMay-Lill Johansen0Bente Ervik1Research Unit for General Practice, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of NorwayDepartment of Oncology, University Hospital of Northern NorwayAbstract Background Caring for people with palliative care needs in their homes requires close collaboration within and between primary and hospital care. However, such close collaboration is often lacking. Transitions of care are potentially unsafe and distressing points in a patient trajectory. Few studies have explored the experiences of healthcare professionals in the community who receive patients from hospital care and provide them with palliative care at home. Objective To explore how rural health professionals experience local and regional collaboration on patients in need of palliative care. Methods This was a qualitative focus group and interview study in rural Northern Norway involving 52 primary care health professionals including district nurses, general practitioners, oncology nurses, physiotherapists, and occupational therapists. Five uni-professional focus group discussions were followed by five interprofessional discussions and six individual interviews. Transcripts were analysed thematically. Results “Talking together” was perceived as the optimal form of collaboration, both within primary care and with specialists. Nurses and GPs had similar perceptions of their worst-case scenario in primary palliative care: the sudden arrival after working hours of a sick patient about whom they lacked information. These situations could be the result of a short notice transfer from secondary care or an emergency presentation after a crisis in patient management locally, the latter often resulting in a hospital admission. Participants missed timely and detailed discharge letters and in complex cases a telephone call or conference. Locally, co-location was perceived as advantageous for crucial communication, mutual support, and knowledge about each other’s competencies and work schedule. Because local health professionals belonged to different units within the primary health care organisation, in some places they had limited knowledge about each other’s roles and skill sets. Conclusions Lack of communication, both locally and between specialist and primary care, was a key factor in the worst-case patient scenarios for GPs and nurses working in primary palliative care in rural Northern Norway. Co-location of primary care professionals promoted local collaboration and should be encouraged. Hospital discharge planning should involve the receiving primary care professionals.https://doi.org/10.1186/s12913-022-07713-zPalliative home careEnd-of-life careGeneral practiceInterprofessional collaborationTransitions of careNorway |
spellingShingle | May-Lill Johansen Bente Ervik Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway BMC Health Services Research Palliative home care End-of-life care General practice Interprofessional collaboration Transitions of care Norway |
title | Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway |
title_full | Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway |
title_fullStr | Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway |
title_full_unstemmed | Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway |
title_short | Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway |
title_sort | talking together in rural palliative care a qualitative study of interprofessional collaboration in norway |
topic | Palliative home care End-of-life care General practice Interprofessional collaboration Transitions of care Norway |
url | https://doi.org/10.1186/s12913-022-07713-z |
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