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. 2019 Sep 18;27(1):88.
doi: 10.1186/s13049-019-0662-y.

Palliative care in the emergency department as seen by providers and users: a qualitative study

Silvia Di Leo  1 , Sara Alquati  2 , Cristina Autelitano  2 , Massimo Costantini  3 , Gianfranco Martucci  2 , Francesco De Vincenzo  4 , Beata Kuczynska  5 , Alessandra Morini  6 , Laura Trabucco  5 , Raffaella Ursicelli  5 , Gianluca Catania  7 , Luca Ghirotto  8
Affiliations

Palliative care in the emergency department as seen by providers and users: a qualitative study

Silvia Di Leo et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Much effort has been made to explore how patients with advanced chronic illness and their families experience care when they attend the Emergency Department, and many studies have investigated how healthcare professionals perceive Palliative Care provision in the Emergency Department. Various models exist, but nonetheless incorporating palliative care into the Emergency Department remains challenging. Considering both healthcare professionals' and users' perspective on problems encountered in delivering and receiving appropriate palliative care within this context may provide important insight into meaningful targets for improvements in quality of care. Accordingly, this study aims at exploring issues in delivering palliative care in the Emergency Department from the perspective of both providers and users, as part of a larger project on the development and implementation of a quality improvement program in Italian Emergency Departments.

Methods: A qualitative study involving focus group interviews with Emergency Department professionals and semi-structured interviews with patients with palliative care needs in the Emergency Department and their relatives was conducted. Both datasets were analyzed using Thematic Analysis.

Results: Twenty-one healthcare professionals, 6 patients and 5 relatives participated in this study. Five themes were identified: 1) shared priorities in Emergency Department among healthcare professionals and patients, 2) the information provided by healthcare professionals and that desired by relatives, 3) perception of environment and time, 4) limitations and barriers to the continuity of care, and 5) the contrasting interpretations of giving and receiving palliative care.

Conclusions: This study provides insights into targets for changes in Italian Emergency Departments. Room for improvement relates to training for healthcare professionals on palliative care, the development of a shared care pathway for patients with palliative care needs, and the optimization of Emergency Department environment. These targets will be the basis for the development of a quality improvement program in Italian Emergency Departments.

Keywords: Emergency Department; Healthcare professional; Improvement program; Palliative Care; Patient; Qualitative research; Relative.

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Conflict of interest statement

The authors declare that they have no competing interests.

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