Implementation of knowledge-based palliative care in acute care settings: obstacles, opportunities and experiences

In this dissertation of 2018 Susanne Lind, Karolinska Institute, Sweden, argues that palliative care should be an issue in acute care settings. As is well-documented, a high proportion of deaths occur in acute care settings, where the care has been described as inadequate for dying patients. Therefore, guidelines for palliative care should be used in such settings to improve quality of care generally.

The study starts to analyze what is known about national policy documents on palliative care documents. The results showed a scarce knowledge at all levels of the healthcare organization. Besides knowledge, another obstacle for implementation of available guidelines, training modules etc. was the culture in hospitals (heavy workload, poor communication, poor teamwork). At the same time, the health care workers in the hospital recognized a need for more knowledge and training.

A strategy was developed to implement the Integrated Palliative care Outcome Scale (IPOS). The strategy included information, training and facilitation to support the use of the scale. Evaluation of this implementation showed that improvements are needed.