Multi-Level Factors Impacting Implementation of Outpatient Palliative Care: Perceptions of VA Providers.

To develop strategies to better meet palliative needs for older adults, it is critical to understand what factors influence the implementation and sustainability of palliative care (PC) in the outpatient setting. This study explored provider perceptions about multi-level factors impacting implementa...

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Publicado en:Journal of Applied Gerontology Vol. 45; no. 3; pp. 453 - 466
Autores principales: Kaufman, Brystana G., Lanford, Tiera J., Sperber, Nina R., Stanwyck, Catherine, Ma, Jessica E., Thorpe, Joshua M., Hastings, S. Nicole, Bekelman, David B., Van Houtven, Courtney H.
Formato: Artículo
Publicado: Sage Publications Inc. Mar2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
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        atl: Multi-Level Factors Impacting Implementation of Outpatient Palliative Care: Perceptions of VA Providers.
      aug:
        au:
          Kaufman, Brystana G.
          Lanford, Tiera J.
          Sperber, Nina R.
          Stanwyck, Catherine
          Ma, Jessica E.
          Thorpe, Joshua M.
          Hastings, S. Nicole
          Bekelman, David B.
          Van Houtven, Courtney H.
        affil:
          Durham VA Health Care System, Durham, NC, USA
          Duke University School of Medicine, Durham, NC, USA
          VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
          University of North Carolina, Chapel Hill, NC, USA
          Eastern Colorado Health Care System, Aurora, CO, USA
          University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
      su:
        United States. Dept. of Veterans Affairs
        Health services accessibility
        Teams in the workplace
        Palliative treatment
        Medical personnel
        Qualitative research
        Interviewing
        Communication
        Labor demand
        Psychosocial factors
        Labor supply
        Outpatient services in hospitals
        Research funding
        Statistical sampling
        Continuum of care
        Descriptive statistics
        Attitudes of medical personnel
        Conceptual structures
        Research methodology
        Employee recruitment
        Clinics
        Data analysis software
        Health care teams
        Medical referrals
      sug:
        subj:
          Health services accessibility
          Teams in the workplace
          Palliative treatment
          Medical personnel
          Qualitative research
          Interviewing
          Communication
          Labor demand
          Psychosocial factors
          Labor supply
          United States. Dept. of Veterans Affairs
          Offices of physicians
          Community health centres
          All Other Outpatient Care Centers
          All other out-patient care centres
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Human Resources Consulting Services
          Temporary Help Services
          Marketing Research and Public Opinion Polling
          Administration of Veterans' Affairs
          Outpatient services in hospitals
          Research funding
          Statistical sampling
          Continuum of care
          Descriptive statistics
          Attitudes of medical personnel
          Conceptual structures
          Research methodology
          Employee recruitment
          Clinics
          Data analysis software
          Health care teams
          Medical referrals
      keyword:
        health systems
        implementation science
        palliative care
        qualitative
        veteran affairs
        health systems
        implementation science
        palliative care
        qualitative
        veteran affairs
      ab: To develop strategies to better meet palliative needs for older adults, it is critical to understand what factors influence the implementation and sustainability of palliative care (PC) in the outpatient setting. This study explored provider perceptions about multi-level factors impacting implementation of outpatient PC. Applying an implementation science framework, barriers and facilitators were identified for key implementation and sustainability concepts within the provider, organizational context, and external levels. Provider perceptions were explored using semi-structured group interviews (n = 11) with 9 outpatient specialty PC teams. Participants (n = 26) included outpatient PC team members and team leaders. Key considerations for health systems seeking to implement or expand outpatient PC include addressing misperceptions, co-location with referring clinical teams, and building the PC workforce to support interdisciplinary PC teams. To address challenges communicating benefits of PC, improved performance measures are needed to document and incentivize appropriate referral and use of PC throughout the continuum of care.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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