Key result
Among 17 health care providers, the HeartFull Collaborative shared care model facilitated knowledge exchange and communication, though individual and system-level barriers to implementation remain.
Why the study?
To evaluate health care provider perspectives of barriers and facilitators to providing coordinated palliative care for patients with advanced heart failure at home within the HeartFull Collaborative.
What are the barriers and facilitators to providing collaborative home-based palliative care for patients with advanced heart failure from the perspective of healthcare providers?
What are the barriers and facilitators to providing collaborative home-based palliative care for patients with advanced heart failure from the perspective of healthcare providers?
A collaborative shared model of care between palliative care and cardiology is acceptable to providers and improves knowledge exchange, though systemic and individual barriers need addressing.
Answers are grounded in this paper and cite their sources.
Supports provider acceptability of shared palliative-cardiology models in advanced HF; leaves open strategies to overcome persistent implementation barriers.
Background The HeartFull Collaborative is a regionally organized model of care which involves specialist palliative care and cardiology health care providers (HCPs) in a collaborative, home-based palliative care approach for patients with advanced heart failure (AHF). We evaluated HCP perspectives of barriers and facilitators to providing coordinated palliative care for patients with AHF at home. Methods and Results We conducted a qualitative study with 17 HCPs (11 palliative care and 6 cardiology) who were involved in the HeartFull Collaborative from April 2013 to March 2020. Individual, semi-structured interviews were held with each practitioner from November 2019 to March 2020. We used an interpretivist and inductive thematic analysis approach. We identified facilitators at 2 levels: (1) individual HCP level (on-going professional education to expand competency) and (2) interpersonal level (shared care between specialties, effective communication within the care team). Ongoing barriers were identified at 2 levels: (1) individual HCP level (e.g. apprehension of cardiology practitioners to introduce palliative care) and (2) system level (e.g. lack of availability of personal support worker hours). Conclusions Our results suggest that a collaborative shared model of care delivery between palliative care and cardiology improves knowledge exchange, collaboration and communication between specialties, and leads to more comprehensive patient care. Addressing ongoing barriers will help improve care delivery. Findings emphasize the acceptability of the program from a provider perspective, which is encouraging for future implementation. Further research is needed to improve prognostication, assess patient and caregiver perspectives regarding this model of care, and assess the economic feasibility and impact of this model of care.
No takes yet. Share an insight, caveat, or question.
Graham et al. (2022) studied Advanced heart failure (n=17). HeartFull Collaborative was evaluated on Health care provider perspectives of barriers and facilitators to providing coordinated palliative care. Among 17 health care providers, the HeartFull Collaborative shared care model facilitated knowledge exchange and communication, though individual and system-level barriers to implementation remain.
Synapse has enriched 10 related papers. Consider them for comparative context: