Authors
- Ian Gwynne-Robson1,
- Roshan Perera2,
- Helen Moriarty2
- Te Omanga Hospice1,
- University of Otago2
2014
Excerpt
The Integrated Pathway of Care at Te Omanga (IMPaCT) study is an action research project to determine the effectiveness and efficiency of a planned change to an integrated model of patient care in the Hutt Valley, New Zealand.
In response to increasing palliative care need in the Hutt Valley and considering the current Primary/Specialist Palliative Care framework from the NZ Ministry of Health, Te Omanga Hospice is examining palliative care delivery in the Hutt Valley as a whole,as well as re-examining its own current two level service structure.
To inform this process of change, the clinical, quality and administrative leadershi p strongly supported by the Te Omanga Hospice Trust and Foundation Boards undertook this research collaboration with University of Otago Wellington.
This action research project began in August 2013 and is exploring change management processes for integration of existing community and hospice based services: competing priorities for the selection of the best care pathway for patients, streamlining service delivery for integrated care, and facilitators and barriers to this process. The project also aims to identify indicators of best practice and quality of care, especially of 'responsiveness' and 'equity of
access'.
A mix of qualitative and quantitative methods is being used to obtain baseline data, and then to investigate changes after the roll out of a pilot of an integrated model. The qualitative arm includes focus group and key informant interviews among Hospice staff, District Health Board stakeholders and funders, General Practitioners in the Hutt Valley, patients and families/carers currently enrolled with the different levels of hospice service.
Results from the completed interviews with Hospice staff will be presented along with preliminary results of the thematic content analysis of interviews conducted with a purposefully selected sample of General Practitioners. Six themes emerged: location of Palliative Care work, referral to Hospice care from the Public System, expansion of General Practice to Palliative Care, challenges, required support, up skilling and measures of service quality.
Statements include: Palliative care was felt to be 'not really different to what we do all the time anyway'. Most GPs indicated that their Palliative Care learning curve and experience in Rest homes had provided huge insight and enabled growth in confidence. The biggest barrier to GPs doing greater PC was time constraints, particularly with complex cases. Timeliness of response as well as face to face contact is important. GPs felt the importance of keeping the care free at end of life. Appropriate funding for GP time needed to be provided.
In response to increasing palliative care need in the Hutt Valley and considering the current Primary/Specialist Palliative Care framework from the NZ Ministry of Health, Te Omanga Hospice is examining palliative care delivery in the Hutt Valley as a whole,as well as re-examining its own current two level service structure.
To inform this process of change, the clinical, quality and administrative leadershi p strongly supported by the Te Omanga Hospice Trust and Foundation Boards undertook this research collaboration with University of Otago Wellington.
This action research project began in August 2013 and is exploring change management processes for integration of existing community and hospice based services: competing priorities for the selection of the best care pathway for patients, streamlining service delivery for integrated care, and facilitators and barriers to this process. The project also aims to identify indicators of best practice and quality of care, especially of 'responsiveness' and 'equity of
access'.
A mix of qualitative and quantitative methods is being used to obtain baseline data, and then to investigate changes after the roll out of a pilot of an integrated model. The qualitative arm includes focus group and key informant interviews among Hospice staff, District Health Board stakeholders and funders, General Practitioners in the Hutt Valley, patients and families/carers currently enrolled with the different levels of hospice service.
Results from the completed interviews with Hospice staff will be presented along with preliminary results of the thematic content analysis of interviews conducted with a purposefully selected sample of General Practitioners. Six themes emerged: location of Palliative Care work, referral to Hospice care from the Public System, expansion of General Practice to Palliative Care, challenges, required support, up skilling and measures of service quality.
Statements include: Palliative care was felt to be 'not really different to what we do all the time anyway'. Most GPs indicated that their Palliative Care learning curve and experience in Rest homes had provided huge insight and enabled growth in confidence. The biggest barrier to GPs doing greater PC was time constraints, particularly with complex cases. Timeliness of response as well as face to face contact is important. GPs felt the importance of keeping the care free at end of life. Appropriate funding for GP time needed to be provided.