Improving the dying situation on non-palliative care wards: Evaluation of the participants’ perspectives on a bottom-up approach

Purpose: In the “Dying in Hospitals - Optimization of Care in the Dying
Phase” project (Funded by the “Innovations-Fond”), multi-professional
working groups (WGs) of health care professionals (HCPs) were established
on ten non-specialist palliative care wards at two university hospitals.
In these researcher-supported WGs, wards-specific measures to
optimize care in the dying phase were developed by using a bottom-up
approach. The experience and satisfaction of the HPCs with the WGs and
the implementation of the measures was evaluated.
Methods: After the WG process, an online survey was sent to all HCPs
who participated in the WGs in January 2023. The survey consisted of 17
closed, self-developed questions on a 3-point Likert scale rating the HCPs’
satisfaction with the content, outcomes of the WGs and the implementation
on the wards. We used descriptive statistics to analyze the results.
Results: A total of 69 WG meetings (mean: 6.9, range: 5-12) were held
with 3-6 HPCs in mean per meeting and a duration of 1-1.5h. Of 78 eligible
HCPs, 48 responded to the survey (63%): 52% nurses, 23% physicians
and 25% psychosocial HPCs. The majority (16 of 17 items) of questions
were rated positively (range: 55-91%). The most valued aspect was the
opportunity to contribute own opinions/topics in the WG process (91%).
Most HCPs would participate again in such WGs (77%) and would recommend
HCPs of other wards to develop own interventions to improve
care in the dying phase (80%). Satisfaction with the developed measures for their wards was 66%. However, 55% reported that implementing the
measures at the ward level had worked well.
Discussion: The results show that implementing a bottom-up approach to
the development of measures by HPCs is possible and positively rated, but
may also face implementation challenges.
Conclusion: The positive ratings and satisfaction with the researcher-supported
WG process indicate the use of a bottom-up strategy to develop
interventions for care in the dying phase on non-specialist palliative
care wards.
Disclosure Statement: The authors declare no conflict of interest.