Virtual Goals of Care Consultation for Advanced Frailty: a Qualitative Implementation Study Providing Insights from the Pandemic.
Background: During the COVID-19 pandemic, long-term care (LTC) facilities faced challenges in establishing appropriate goals of care (GoC) for residents during health crises. To address this, a virtual specialist consultation program was implemented to align care interventions with residents' frailt...
| Publicado en: | Canadian Geriatrics Journal Vol. 28; no. 1; pp. 1 - 16 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Canadian Geriatrics Society
Mar2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=183499141&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 183499141 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19258348 EV2Z jtl: Canadian Geriatrics Journal issn: 19258348 maglogo: N pubinfo: dt: Mar2025 vid: 28 iid: 1 pid: 76420 pub: Canadian Geriatrics Society place: Markham, Ontario artinfo: ui: 183499141 183499141 183499141 10.5770/cgj.28.759 183499141 ppf: 1 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Virtual Goals of Care Consultation for Advanced Frailty: a Qualitative Implementation Study Providing Insights from the Pandemic. aug: au: Shetty, Nabha MacLeod, Tanya Miller, Ashley Paige Buckler, Melissa Mallery, Laurie Krueger-Naug, Anne-Marie von Maltzahn, Maia Moorhouse, Paige affil: Dalhousie University, Faculty of Medicine, Department of Medicine, Halifax sug: subj: Remote Consultation Program Implementation Program Evaluation Frailty Syndrome Advance Care Planning Long Term Care Human Qualitative Studies Implementation Science COVID-19 Pandemic Male Female Structured Interview Leadership Coding Conceptual Framework Thematic Analysis Quality Improvement Acute Care Funding Source Male Female ab: Background: During the COVID-19 pandemic, long-term care (LTC) facilities faced challenges in establishing appropriate goals of care (GoC) for residents during health crises. To address this, a virtual specialist consultation program was implemented to align care interventions with residents' frailty and expected outcomes. Methods: We explored barriers and enablers to the implementation and sustainability of the program using structured interviews (n=20) with LTC leadership, health-care staff, and members of the program. Data were coded according to the constructs of the Consolidated Framework for Implementation Research (CFIR) using thematic analysis. Results: Participants described how the program improved care and reduced unnecessary transfers. Implementation was enabled by a high degree of tension for change, relative priority, relative advantage, and the team's shared mental model of frailty-care. Inconsistencies in GoC approaches and information silos between LTC and acute-care challenged implementation. Sustainability was hindered by decreased pandemic urgency, resulting in reallocation of resources to usual care. The need for a specialized GoC service in LTC became less obvious outside of a crisis. Conclusions: This implementation study provides important insights for future spread and scale of embedding virtual specialist consultation services into LTC. The findings underscore the importance of collegial relationships and shared care philosophies to effectively implement frailty-informed care initiatives during crises. However, sustaining cross-sectoral GoC services may be challenging amidst evolving workloads and prevailing cultural perceptions of end-of-life care needs. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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