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...
| Publicado en: | Journal of Applied Gerontology Vol. 45; no. 3; pp. 453 - 466 |
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| Autores principales: | , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Sage Publications Inc.
Mar2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=191375765&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 191375765 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 07334648 JGR jtl: Journal of Applied Gerontology issn: 07334648 maglogo: Y pubinfo: dt: Mar2026 vid: 45 iid: 3 pid: 344 pub: Sage Publications Inc. artinfo: ui: 191375765 10.1177/07334648251343484 ppf: 453 ppct: 13 formats: tig: 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 refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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