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BMC Health Services Research
Published in: BMC Health Services Research 1/2020

Open Access 01-12-2020 | Care | Research article

Impact, challenges and limits of inpatient palliative care consultations – perspectives of requesting and conducting physicians

Authors: Anja Coym, Karin Oechsle, Alena Kanitz, Nora Puls, David Blum, Carsten Bokemeyer, Anneke Ullrich

Published in: BMC Health Services Research | Issue 1/2020

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Abstract

Background

Inpatient palliative care consultation (IPCC) teams have been established to improve care for patients with specialist palliative care (PC) needs throughout all hospital departments. The objective is to explore physicians’ perceptions on the impact of IPCC, its triggers, challenges and limits, and their suggestions for future service improvements.

Methods

A Qualitative study drawing on semi-structured interviews with 10 PC specialists of an IPCC team and nine IPCC requesting physicians from oncology and non-oncological departments of a university hospital. Analysis was performed using qualitative content analysis.

Results

PC specialists and IPCC requesting physicians likewise considered organization of further care and symptom-burden as main reasons for IPCC requests. The main impact however was identified from both as improvement of patients’ (and their caregivers’) coping strategies and relief of the treating team. Mostly, PC specialists emphasized a reduction of symptom burden, and improvement of further care. Challenges in implementing IPCC were lack of time for both. PC specialists addressed requesting physicians’ skepticism towards PC. Barriers for realization of IPCC included structural aspects for both: limited time, staff capacities and setting. PC specialists saw problems in implementing recommendations like disagreement towards their suggestions. All interviewees considered education in PC a sensible approach for improvement.

Conclusions

IPCC show various positive effects in supporting physicians and patients, but are also limited due to structural problems, lack of knowledge, insecurity, and skepticism by the requesting physicians. To overcome some of these challenges implementation of PC education programs for all physicians would be beneficial.
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Metadata
Title
Impact, challenges and limits of inpatient palliative care consultations – perspectives of requesting and conducting physicians
Authors
Anja Coym
Karin Oechsle
Alena Kanitz
Nora Puls
David Blum
Carsten Bokemeyer
Anneke Ullrich
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Health Services Research / Issue 1/2020
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-020-4936-x

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