"Never waste a good crisis": A qualitative study of the impact of COVID-19 on palliative care in seven hospitals using the Dynamic Sustainability Framework.
Background: The COVID-19 pandemic led to rapid adaptations among palliative care services, but it is unclear how these adaptations vary in relation to their unique organizational contexts. Aim: Understand how the pandemic impacted the implementation of new and existing palliative care programs in di...
| Published in: | Palliative Medicine Vol. 36; no. 10; pp. 1544 - 1552 |
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| Main Authors: | , , , |
| Format: | research tables/charts Journal Article |
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Sage Publications Inc.
Dec2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=160754946&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 160754946 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02692163 31I jtl: Palliative Medicine issn: 02692163 maglogo: Y pubinfo: dt: Dec2022 vid: 36 iid: 10 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 160754946 159891773 160754946 160754946 10.1177/02692163221123966 160754946 ppf: 1544 ppct: 8 formats: tig: atl: "Never waste a good crisis": A qualitative study of the impact of COVID-19 on palliative care in seven hospitals using the Dynamic Sustainability Framework. aug: au: Holdsworth, Laura M Mui, Heather Z Winget, Marcy Lorenz, Karl A affil: Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA sug: subj: COVID-19 Pandemic Psychosocial Factors Palliative Care Hospitals Human Qualitative Studies Thematic Analysis Interviews Advance Care Planning Hardiness Implementation Science ab: Background: The COVID-19 pandemic led to rapid adaptations among palliative care services, but it is unclear how these adaptations vary in relation to their unique organizational contexts. Aim: Understand how the pandemic impacted the implementation of new and existing palliative care programs in diverse hospital systems using the Dynamic Sustainability Framework. Design: Twelve in-depth interviews with 15 key informants representing palliative care programs from seven hospital systems between April and June 2020. Setting: Public, not-for-profit private, community, and academic teaching hospitals in the San Francisco Bay Area with existing palliative care programs that were expanding services to new clinical areas (e.g. new outpatient clinic or community-based care). Results: Six themes characterized how palliative care programs were impacted and adapted during the early stages of the COVID-19 pandemic: palliative care involvement in preparing for surge, increased emphasis on advance care planning, advocating for visitors for dying patients, providing emotional support to clinicians, adopting virtual approaches to care, and gaps in chaplaincy support. There was variation in how new and existing programs were able to adapt to early pandemic stresses; systems with new outpatient programs struggled to utilize their programs effectively during the crisis onset. Conclusions: The fit between palliative care programs and practice setting was critical to program resiliency during the early stages of the pandemic. Reconceptualizing the Dynamic Sustainability Framework to reflect a bidirectional relationship between ecological system, practice setting, and intervention levels might better guide implementers and researchers in understanding how ecological/macro changes can influence interventions on the ground. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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