Analysis of Palliative Care Process through SAP-LAP Inquiry: Case Study on Palliative Care and Training Centre

Abstract

‘Palliative care’, a branch of medicine, aims to alleviate pain and enhance quality of life in the patient suffering from life-threatening illnesses. In addition to regular curative treatment for the patient, it also provides bereavement support to the family thereafter. Search for exhaustive literature on palliative care initiatives and current status in India confirms a dearth for nationwide awareness as well as published literature concerning the performance of palliative care units. While only few institutions are involved in disseminating palliative care initiatives, the services are quite limited, demanding a need to consider this topic holistically. Conclusively, palliative care should address every aspect of health care and support to the ailing patient and their family members. The purpose of this paper is to analyse the palliative care process adopted by the case institution, i.e. a renowned Palliative Care and Training Centre (PCTC-1) in India, to discuss the palliative care initiatives and their performance outcomes. A situation–actor–process and learning–action–performance (SAP-LAP) model of inquiry has been applied for the case study (PCTC-1). It considers the present operations of the centre and actors as participants influencing the situation through different processes. Several pertinent issues leading to actions have been analysed, which have considerable impact on the delivery of palliative care services. Responses elicited through in-depth interviews with the actors form the basis of primary data along with the published secondary sources. PCTC-1 has undertaken numerous initiatives such as ‘care beyond cure’, ‘wearing smiles’ and rendering health care at the centre as well as homes. Issues related to spreading awareness and holistic services on palliative care demands priority. The government national healthcare system needs to include palliative care as a core programme for people inclusion. Presently, palliative care services in India are negligible, and people lack awareness about it. This study uses SAP-LAP inquiry as a novel approach, which attempts to analyse and synthesise the processes holistically in a single study on the performance of palliative care services rendered only by the case organisation (PCTC-1). The findings of this study could be widely used for managerial problem-solving experienced by other palliative care centres. Further empirical tests can be undertaken in the palliative care sector for deriving deeper linkages in the model.