Overview of Action Research Project carried out to integrate palliative care into the care of those with respiratory illness. Presented at International Congress on Palliative Care, Montreal, September 2014

1. Effective integration of Palliative Care in Respiratory Setting – Using
Action Research
Marie Lynch, Bettina Korn, Patricia White PhD

2. Introduction
1. Context
2. Methods of
integration
3. Results
4. Key learning
No conflict of interest
2010 2013 Project
Duration

3. Patients Barriers Sites
I always think of palliative
care as just cancer.
Patient 1 Patient 4
I remember it frightened me,
the mention of it, it also
frightened me more when
they said morphine, I think
most people think morphine
is for people on the way out.

4. Education Needs - Baseline
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Currently have a Palliative
Care Qualification
Interested in Attending
Palliative Care Education
yes
no
All health care staff on the respiratory ward (nurses, doctors, care assistants, physiotherapists)
42/49 questionnaires returned (86% response rate)

5. Action Research
• Recognised method
for quality
improvement &
organisational
change
• Approach requires
– Collaboration
– Empowerment
– Reflection

6. Demonstrate 2 methods of integration
Collaboration Developing Knowledge

7. End of life care
review meetings
Developing
Knowledge:
Facilitating questions:
•What went well in the care of this patient and
their family at the end of life?
•What didn’t go so well?
•What would we do differently?
•Would the way this person died be
acceptable to me?

8. Formal Education
Clinical education input: End of life care awareness &
communication skills training:
Developing
Knowledge:

9. Project steering group
14 Steering
group meetings
over 18 month
period
Focus group
with members
– pre and post
project
timelines
collaboration

10. Working Together:
Journey to improve patient centred care
Respiratory
Team
Specialist
palliative care
team
Patient
collaboration

11. Developing the pathway

12. RESULTS - quantitative
Number of patients accessing palliative care 44

13. RESULTS - qualitative
Patients
Staff
“I wouldn’t be afraid to go
into it (hospice) if I had to
go into it someday where I
would have been before.”
Patient 2
‘The greatest achievement
is the shared approach
that now exists between
the hospice and the
respiratory unit’.
Respiratory Nurse
It (day hospice) gave you
an idea what the future
might hold and how you
could deal with it and that
was comforting in itself.
I do think that it would have
been less effective if it had been
a traditional research project…
you’d be able to stand up… and
present the data but that would
have no impact on the patient.
Respiratory
Physician
Patient 3

14. RESULTS Addressing the barriers
Additional policy and knowledge transfer benefits

15. Reflection
More focus on
quantitative data
‘ Respiratory and palliative care
knowledge based values and world
views have come together and we
have generated a new practice
based knowledge base’.
‘There are effects we can’t measure… [for
example with] the MDT meetings, there
was so much learning that happened
within the Respiratory Assessment Unit
and staff on the ward and [all] that does
filter through and the relationships that
were built’ .
How do we
know what
makes a
difference to
patient care?
Respiratory
Nurses

16. To Conclude The Patient Voice
• Thanks to Eamonn Rooney
– The Meaning of Palliative Care
– The Difference it Makes