Implementation of improvement strategies in palliative care: an integrative review

Implementation Science

Yvonne Engels⁵  Kris Vissers⁵  Wojciech Leppert¹  Marianne J. Hjermstad⁷  Wendy Moyle⁴  Ragni Sommerbakk³  Myrra Vernooij-Dassen²  Jasper van Riet Paap⁶ 

[1] Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, 61-245, Poland;Kalorama Foundation, Nijmegen, The Netherlands;European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, N-7491, Norway;Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, 170 Kessels Road, Nathan, Brisbane, Australia;Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, 6500 HB, The Netherlands;Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, 6500 HB, The Netherlands;Regional Centre for Excellence in Palliative Care Department of Oncology, Oslo University Hospital, Nydalen 0424, Oslo, Norway

关键词: Improvement strategies;    Implementation;    Europe;    Palliative care;   

Others  :  1228861
DOI  :  10.1186/s13012-015-0293-2

 received in 2014-12-22, accepted in 2015-07-11,  发布年份 2015

【 摘 要 】

Background

The European population is ageing, and as a consequence, an increasing number of patients are in need of palliative care, including those with dementia. Although a growing number of new insights and best practices in palliative care have been published, they are often not implemented in daily practice. The aim of this integrative review is to provide an overview of implementation strategies that have been used to improve the organisation of palliative care.

Methods

Using an integrative literature review, we evaluated publications with strategies to improve the organisation of palliative care. Qualitative analysis of the included studies involved categorisation of the implementation strategies into subgroups, according to the type of implementation strategy.

Results

From the 2379 publications identified, 68 studies with an experimental or quasi-experimental design were included. These studies described improvements using educational strategies (n = 14), process mapping (n = 1), feedback (n = 1), multidisciplinary meetings (n = 1) and multi-faceted implementation strategies (n = 51). Fifty-three studies reported positive outcomes, 11 studies reported mixed effects and four studies showed a limited effect (two educational and two multi-faceted strategies).

Conclusions

This review is one of the first to provide an overview of the available literature in relation to strategies used to improve the organisation of palliative care. Since most studies reported positive results, further research is needed to identify and improve the effects of strategies aiming to improve the organisation of palliative care.

【 授权许可】

   
2015 van Riet Paap et al.

【 图 表 】

Fig. 1.

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