Leadership's perceptions of palliative care during the COVID-19 pandemic: a qualitative study

Abstract

Palliative care played a leading role in the COVID-19 pandemic. However, little is known regarding health system leadership's perceptions. This study aimed to explore the perceptions, understanding, and utilization of palliative care before compared to during the COVID-19 pandemic among health system leadership. Semi-structured, in-depth interviews were conducted with leaders in a large healthcare system based in Massachusetts, United States. 22 in-depth interviews were completed at four facilities. Emerging themes included the role of palliative care before compared to during the COVID-19 pandemic, facilitators and barriers to palliative care delivery, and recommendations for future practice. Participants reported that the COVID-19 pandemic increased palliative care utilization, reinforced positive perceptions of the specialty, and emphasized its role in maximizing healthcare efficiency. Many participants found palliative care financing to be a barrier to delivery; some had an inaccurate understanding of how palliative care is reimbursed. When asked about their recommendations for improving future practice, participants noted improvements in coordination within the healthcare system and education of healthcare providers and future physicians in primary palliative care skills. Our findings suggest that health leadership increasingly understand the value of palliative care and its critical role within the health system and during future public health emergencies; this was further reinforced during the COVID-19 pandemic. Healthcare leadership recognize and highlight the need to increase investments in this specialty, both financially and educationally. In doing so, health care costs will be lowered, patient satisfaction will increase, and care will be better coordinated.