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Advancing Palliative Care: Insights from Qualitative Interviews

Gain valuable insights into challenges and opportunities faced by palliative care providers and learn how to improve dialogue around palliative care issues. Explore breakthroughs, access barriers, and the role of CCCP in supporting palliative care efforts.

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Advancing Palliative Care: Insights from Qualitative Interviews

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  1. Taking Palliative Care Upstream:Lessons from Qualitative Interviews Kerry Case, MD Wheaton Franciscan Healthcare

  2. WI CCCP staff goals: understand challenges + opportunities faced by PC providers how CCCP can support PC efforts improve dialogue around PC issues (the brainchild, and labor, of Jeanne Strickland)

  3. Interview Process • One-to-one • In person or by phone • July to September 2012

  4. Interviewees • Volunteers from PC chapter/interest group • Roles included • Hospice administrators • Nurse navigators • Hospice nurses • Social workers • PC physicians • Oncologists • 16 interviews conducted

  5. Topics Addressed • Key PC breakthroughs in past few years? • Populations without PC access? • Challenges to delivery of PC to cancer pts? • Role CCCP should play? • Who is missing from conversation? • What other questions should be asked?

  6. Key Recent Breakthroughs? • Increased awareness re: PC • Specialty designation • Integration into treatment • Data re value of PC

  7. Populations without PC Access? • Rural • Tribal • Homeless • Disabled; mentally ill • Young adults • Patients

  8. Challenges in Provision to Cancer Pts? • Association of PC with EOL • Focus on cure/improvement despite late stage • Referrers’ fear that pts will lose hope • Lack of time in pt’s clinic/hospital stay • Lack of trust amongst providers • Fear of ‘leading’ pts to PC

  9. Opportunities to Serve Cancer Pts? • Potential to reframe “hope” • Cancer trajectory predictability • Disease process can anchor discussions • Oncologists can be trained in GOC • Criteria to trigger referral/standardize referrals

  10. Role for WI CCCP? • Statewide community to address training, advocacy issues • Education re resources already available • Forums to discuss and standardize practices • Sample system policies for PC as std of care • Promote “there is not one way to deliver PC” • Encourage ongoing research • Be vocal supporter

  11. Who is Missing? • Underserved populations • PC representative on the WI CCC Steering Committee • ‘team needs to include chaplaincy, social workers, MLP, oncology nurses, cactr admin, pc nurses and grief counselors’

  12. Other Questions? • Continue asking who else should be present • How can HOPE and WI CCCP work together? • What will systems need to incorporate shared-decision making? • How does ACP impact PC? • How can we support PC coverage for outpts? • How will ACA support PC?

  13. Summary • Definition and integration of PC • Need for education • Policy and advocacy support by cancer council

  14. Kerry Case kcase915@gmail.com Jeanne Strickland jsstrickland@uwcarbone.wisc.edu

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