Interdisciplinary Palliative Research Articles

Overcoming Geographical Barriers: A Distance Mediated Interdisciplinary Palliative Care Seminar

Overcoming Geographical Barriers: A Distance Mediated Interdisciplinary Palliative Care Seminar

“Yes, and…”: Improvisational Theater (Improv) as a Novel Educational Tool in Interdisciplinary Palliative Care

“Yes, and…”: Improvisational Theater (Improv) as a Novel Educational Tool in Interdisciplinary Palliative Care

Identifying the Unmet Needs of People Living With Amyotrophic Lateral Sclerosis: A National Survey to Inform Interdisciplinary Palliative Care.

Introduction/Aims: This national survey builds on previous qualitative research examining potential palliative care needs among people living with ALS (pALS) by quantifying and investigating relationships among pALS' stage of illness progression; physical, emotional, social, spiritual, and intimacy-related concerns; advance care planning behaviors; perceptions of feeling heard and understood by healthcare providers; and overall quality of life. Methods: Researchers partnered with national organizations to recruit pALS to participate in a one-time survey comprising items from validated instruments (eg, the ALS Specific Quality of Life Instrument-Revised) and researcher-generated measures. Data were analyzed using logistic and linear regression. Results: Among pALS (n = 112), many respondents indicated they had discussed their wishes for end-of-life care with family or friends, shared their wishes with providers, and documented their wishes in writing (79.5%, 49.1%, and 63.4%, respectively). Mean (M) quality of life scores were moderate (M ≈ 6 of 10). Illness stage was associated with documentation of end-of-life care wishes but not with having discussed these wishes with others or with overall quality of life. Reported emotional intimacy received was comparable to that desired (difference = .01 of 10); however, a greater desire for physical intimacy relative to that received was indicated (difference = 1.75 of 10). Discussion: Interdisciplinary palliative care teams may enhance ALS care by promoting advance care planning behaviors (particularly discussing one's wishes with healthcare providers), providing interventions to improve quality of life, and supporting pALS in navigating challenges related to physical intimacy.

Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar.

The COVID-19 pandemic created a unique opportunity to evolve an interdisciplinary palliative care seminar (IPC) into a virtual platform. This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and incorporates interdisciplinary student led patient encounters. Traditionally, this experience had been in person, however during the COVID-19 pandemic, healthcare restrictions transitioned the educational delivery to a virtual platform. To assess the knowledge gained from this novel experience, the Palliative Care Knowledge Test (PCKT) was administered before and after the IPC Seminar. A 1-year follow up survey was also administered to evaluate how the IPC Seminar was applicable to the students' clinical experiences and practice. The virtual didactics and virtual student led patient encounters significantly improved learners understanding of palliative and hospice care. This gain of knowledge was noted across undergraduate and graduate programs, which highlights the need for and benefit from foundational concepts. Furthermore, a 1-year follow up survey noted the IPC seminar was applicable to their practices and suggests that this experience will impact future patients. Many of the students practice in rural areas where access to palliative care services is limited or non-existent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region. Evolving our IPC Seminar has shown to significantly improve knowledge, foster collaboration of student led interdisciplinary teams, and increases capacity to meet the needs of more learners.

A Cerebellar Catastrophe in the Hospice Ward: How a Patient with Cerebellar-Metastatic Breast Cancer with Multiple Manifestations of Cerebellar Disease was Effectively Treated by an Interdisciplinary Palliative Care Team (CS309)

A Cerebellar Catastrophe in the Hospice Ward: How a Patient with Cerebellar-Metastatic Breast Cancer with Multiple Manifestations of Cerebellar Disease was Effectively Treated by an Interdisciplinary Palliative Care Team (CS309)

Comparison of Virtual Versus Live OSCE (Objective Structured Clinical Examination) Within an Interdisciplinary Palliative Care Training Program (QI410)

Comparison of Virtual Versus Live OSCE (Objective Structured Clinical Examination) Within an Interdisciplinary Palliative Care Training Program (QI410)

Practice Improvement Projects in an Interdisciplinary Palliative Care Training Program.

Demand for palliative care (PC) continues to increase with an insufficient number of specialists to meet the need. This requires implementation of training curricula to expand the workforce of interdisciplinary clinicians who care for persons with serious illness. To evaluate the impact of utilizing individual practice improvement projects (PIP) as part of a longitudinal PC curriculum, the Coleman Palliative Medicine Training Program (CPMTP-2). Participants developed their PIPs based on their institutional needs and through a mentor, and participated in monthly meetings and bi-annual conferences, thereby allowing for continued process improvement and feedback. Thirty-seven interdisciplinary participants implemented 30 PIPs encompassing 7 themes: (1) staff education; (2) care quality and processes; (3) access to care; (4) documentation of care delivered; (5) new program development; (6) assessing gaps in care/patient needs; and (7) patient/family education. The majority of projects did achieve completion, with 16 of 30 projects reportedly being sustained several months after conclusion of the required training period. Qualitative feedback regarding mentors' expertise and availability was uniformly positive. The CPMTP-2 demonstrates the positive impact of PIPs in the development of skills for interdisciplinary learners as part of a longitudinal training program in primary PC. Participation in a PIP with administrative support may lead to operational improvement within PC teams.

Responding to Community Needs During COVID-19: A Virtual, Interdisciplinary Palliative Care Education Series for the Public (QI722)

COVID-19 raised public concerns about planning for and coping with serious illness and death. Social distancing and shelter-in-place orders made leveraging virtual platforms essential in providing the public with access to palliative care experts who could help address these concerns.

Communication Skills Training for Nurses and Social Workers: An Initiative to Promote Interdisciplinary Advance Care Planning and Palliative Care in Patients on Dialysis

Communication Skills Training for Nurses and Social Workers: An Initiative to Promote Interdisciplinary Advance Care Planning and Palliative Care in Patients on Dialysis

Young Adult Experience in an Outpatient Interdisciplinary Palliative Care Cancer Clinic.

Young adults (YAs; defined as 18-39 years of age) with advanced cancer are a group for whom standardized age-appropriate palliative care has not been established. The purpose of this study was to explore the YA experience and perceptions of palliative care in an outpatient interdisciplinary palliative care clinic for this population. Using an interpretive descriptive design, semistructured interviews were conducted with 12 YAs with advanced cancer who were being seen jointly by a palliative care physician and psychiatrist in an ambulatory palliative care clinic. Interviews explored participants' understanding and experiences of receiving palliative care. Six family members were also interviewed to build on the YA experience. Data collection and analysis occurred concurrently, drawing on the constructivist grounded theory method to analyze the data. Participants described being referred to and seen in the interdisciplinary palliative care clinic as a conflicting and at times difficult experience because of the feeling of being categorized as palliative as YAs. Even so, there were key aspects associated with the specific palliative care approach that allowed YAs to cope with this new label, leading to a beneficial experience, specifically: provided YAs with time and space to explore the experience of having cancer at a younger age, created repeat opportunities to talk openly with people who "got it," and highlighted the importance of including family support in the care of YAs. YAs who were referred to the interdisciplinary palliative care clinic struggled with the category of palliative care but also found the care they received beneficial. Findings provide an approach to palliative care tailored to YAs with advanced cancer.

Expanding the Interdisciplinary Palliative Medicine Workforce: A Longitudinal Education and Mentoring Program for Practicing Clinicians

ContextThe disparity between gaps in workforce and availability of palliative care (PC) services is an increasing issue in health care. To meet the demand, team-based PC requires additional educational training for all clinicians caring for persons with serious illness. ObjectivesTo describe the educational methodology and evaluation of an existing regional interdisciplinary PC training program that was expanded to include chaplain and social worker trainees. MethodsFrom 2015 to 2017, 26 social workers, chaplains, physicians, nurses, and advanced practice providers representing 22 health systems completed a two-year training program. The curriculum comprises biannual interdisciplinary conferences, individualized mentoring and clinical shadowing, self-directed e-learning, and profession-focused seminar series for social workers and chaplains. Site-specific practice improvement projects were developed to address gaps in PC at participating sites. ResultsPC and program development skills were self-assessed before and after training. Among 12 skills common to all disciplines, trainees reported significant increases in confidence across all 12 skills and significant increases in frequency of performing 11 of 12 skills. Qualitative evaluation identified a myriad of program strengths and challenges regarding the educational format, mentoring, and networking across disciplines. ConclusionTeaching PC and program development knowledge and skills to an interdisciplinary regional cohort of practicing clinicians yielded improvements in clinical skills, implementation of practice change projects, and a sense of belonging to a supportive professional network.

"Online Training Is Great but Human Interaction Is Better": Training Preferences of VA Interdisciplinary Palliative Care Consult Teams.

A growing body of research has examined modalities for delivering palliative care education; however, we know little about education and training preferences of VA interdisciplinary Palliative Care Consult Teams (PCCT). In the BEACON II study, we explored training preferences of PCCTs from 46 Veterans Affairs Medical Centers (VAMCs) participating in either a multisite webinar or a small group, in-person workshop. We interviewed participants by telephone seven to eight month post-training. In all, 75.9% preferred in-person education and training, including 78.9% of workshop participants and 73.1% of webinar participants. Respondents described in-person training as fostering learning through the following processes: (1) active engagement and focus, (2) interaction and networking, (3) meaning-making and relevance, and (4) reciprocity and commitment. Although it is not possible for Web-based palliative care education programs to replicate all aspects of the in-person learning experience, building experiential, interactive, meaningful, and reciprocal components into Web-based education may help shift preferences and make interdisciplinary team-based palliative care education accessible to a larger audience.

Mentored Learning Communities (MLC) in a Regional Interdisciplinary Palliative Care Training Program (S754)

Mentored Learning Communities (MLC) in a Regional Interdisciplinary Palliative Care Training Program (S754)

Weekly Rounds with Interdisciplinary Palliative Care Consult Team and Prognostication for Hematology/Oncology Inpatients (QI652)

Weekly Rounds with Interdisciplinary Palliative Care Consult Team and Prognostication for Hematology/Oncology Inpatients (QI652)

Balancing Democracy with Efficiency: Strategies for Leading an Interdisciplinary Palliative Care Team (SA505)

•Identify common challenges encountered by leaders of an interdisciplinary palliative care team.•Describe conventional models of team leadership and their application to interdisciplinary palliative care teams.•Explore the successes and pitfalls of a novel leadership model built by an interdisciplinary palliative care team. One of the most celebrated attributes of palliative care (PC) is its interdisciplinary nature. PC teams often include providers from an array of disciplines, including medicine, nursing, social work, pharmacy, and pastoral care. There is little doubt that patients and families facing serious illness benefit from a comprehensive and collaborative approach that employs a broad range of knowledge and skill sets. Yet the same diversity that renders PC so effective for patients may create challenges in maintaining healthy, integrated, and efficient PC teams. PC providers come to the specialty through a variety of training pathways with varied pedagogical and philosophical approaches to education and patient care, and individuals often have significant differences in career and life experience prior to entering the field. This may lead to widely differing perspectives among team members about how to best approach patient care delivery, and in developing PC program vision and strategy. Leaders of interdisciplinary teams face unique challenges in meeting the needs of individual team members, while also fostering team unity around a common vision. Achieving a healthy balance between democracy and efficiency on an interdisciplinary team is crucial. This presentation will explore common challenges faced by leaders of an interdisciplinary PC team, including barriers to communication, decision-making, and goal setting. Strategies to address these challenges will be addressed. Several leadership models will be explored, with an emphasis on the potential benefits and burdens of each model for an interdisciplinary PC team. Finally, a four-person interdisciplinary panel of PC providers will share their experience building a novel leadership model for their PC team. The panel will explore the challenges of creating a culture that ensures the interests of all team members are represented, while also promoting clinical and administrative efficiency, and encouraging educational initiatives. Interactive audience participation will be encouraged.

Evaluation Tools for Interdisciplinary Palliative Care Learning Experiences: A Literature Review.

Background: An interdisciplinary palliative care team began exploring evaluation tools used to assess changes in the knowledge, skills, and attitudes of learners participating in clinical learning experiences on an interdisciplinary palliative care consult service. This article will review existing evaluation tools, examine the themes that emerge, discuss their strengths and limitations, and make recommendations for continued development in the field. Methods and Findings: A literature search was performed using the MEDLINE database. Search terms included combinations of the following: interdisciplinary education, assessment/evaluation, and palliative care or palliative care assessment/test. Four hundred eighty-seven articles were captured during the initial search. Articles that focused on student readiness for interdisciplinary education and team self-assessments of current interdisciplinary collaboration practices were excluded. Nine articles were included in the review. Evaluation tools varied in terms of learner type, assessment type, and frequency. No tool was comprehensive in the assessment of knowledge, skills, and attitudes or truly interdisciplinary. Conclusions: There is a lack of comprehensive and interdisciplinary evaluation tools in the published literature. Further research should be conducted to develop a tool that meets the needs of learners in clinical experiences within an interdisciplinary service.

Advantages and Challenges of an Interdisciplinary Palliative Care Team Approach to Surgical Care.

Palliative care is an interdisciplinary field that focuses on optimizing quality of life for patients with serious, life-limiting illnesses and includes aggressive management of pain and symptoms; psychological, social, and spiritual support; and discussions of advance care planning, including treatment decision making and complex care coordination. Early palliative care is associated with increased quality of life, decreased symptom burden, decreased health care expenditures, and improved caregiver outcomes. This article discusses integrating interdisciplinary palliative care into surgical practice, and some current models of using and expanding palliative care skill sets in surgery, including training initiatives for both physicians and nurses.

End-of-Life Nursing and Education Consortium Communication Curriculum for Interdisciplinary Palliative Care Teams.

Background: Expert communication skills are essential for the delivery of effective palliative care across the domains of care. However, few health care providers receive formal communication training. To promote communication education for interdisciplinary palliative care teams, a train-the-trainer course for interdisciplinary hospital-based palliative care teams was developed to prepare them to teach other health care professionals communication skills. Course Design: The curriculum was organized by the eight domains of the National Consensus Project Guidelines for Quality Palliative Care and provided communication skills training for California-based teams. The two-day train-the-trainer course included skill-building exercises and interactive discussions to assist participants in integrating communication skills building into their clinical settings. Using a goal-directed method of teaching, faculty assisted teams in developing three institutional goals for providing palliative care communication training to other health care professionals. Evaluation of the course included immediate postcourse evaluation and follow-up evaluation at six and nine months. Results: The first statewide interdisciplinary communication training took place in January 2018 with 26 palliative care teams consisting of primarily nurses, followed by social workers, chaplains, and physicians. The 46 course participants' postcourse evaluations demonstrated high satisfaction with the course. On a scale of 1 to 5 (1 = lowest), the course met participants' expectations and objectives (4.8). The teams' precourse goals focused on (1) staff education, training, and mentorship, and (2) institution-wide system changes. Conclusion: Palliative care interdisciplinary teams can incorporate communication skills into their practice and provide communication skills training to their institutions.

Outcomes of collaborative and interdisciplinary palliative education for health care assistants: A qualitative metasummary.

To explore collaborative and interdisciplinary palliative educational strategies and corresponding outcomes for health care assistants. Health care assistants are frontline staff who provide almost all hands-on care to seniors. Health care managers are responsible to provide ongoing support and a working environment conducive to health care assistants' abilities to provide quality, safe, evidence-based care. A Qualitative metasummary of collaborative and interdisciplinary teaching strategies was conducted following guidelines developed by Sandelowski et al. (). The gold standard of palliative care is interdisciplinary delivery of care, yet education is often monodisciplinary. Furthermore, evaluation of interdisciplinary continuing education is most often subjective via self-report questionnaires. Findings from 16 articles representing 15 studies conducted between 2007 and 2017 were grouped thematically and summarized. Collaborative or interdisciplinary palliative interventions offer health care assistants opportunities to debrief, build their confidence, and critically reflect on the importance of psychosocial care for patients, family and colleagues. The metasummary provides six suggestions for managers who are considering implementing a collaborative palliative educational workshop and draws attention to the need to create contextual changes that support health care assistants to enact newly acquired knowledge and skills.

Physical Therapy in Interdisciplinary Palliative Care and Hospice Teams

DEMONSTRATING VALUE WITHIN THE INTERDISCIPLINARY TEAMIn the management of patients with a life-threatening illness or late-stage chronic disease, increased side effects and ineffective or unnecessary treatment may be encountered if medical care is disjointed.1 When not in close communication, multip