Barriers to achieving care at home at the end of life: transferring patients between care settings using patient transport services
Publication date
2009Keyword
After-Hours Care/organization & administrationAmbulances/organization & administration/supply & distribution
*Attitude to Death
Caregivers/psychology
Charities
Focus Groups
Great Britain
*Home Care Services
Humans
Palliative Care/*organization & administrationPatient PreferencePatient Transfer/*organization & administrationQualitative ResearchResuscitation Orders/legislation & jurisprudenceTerminally Ill/psychologyTime FactorsTransportation of Patients/legislation & jurisprudence/*organization &administration/standards
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Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdom by the Marie Curie Cancer Care 'Delivering Choice Programme'. This article explores perceptions of service users and key stakeholders of palliative care services about problems encountered in journeys between care settings during end-of-life care. This article draws on data from interviews with stakeholders (n = 44), patients (n = 16), carers (n = 19) and bereaved carers (n = 20); and focus groups (n = 9) with specialist nurses. Data were gathered in three areas of the United Kingdom. Data were analysed using a framework approach. Transport problems between care settings emerged as a key theme. Four particular problems were identified: (1) urgent need for transport due to patients' rapidly changing condition; (2) limited time to organise transfers; (3) the management of specialist equipment and (4) the need to clarify the resuscitation status of patients. Partnership working between Ambulance Services and secondary care is required to develop joint protocols of care to ensure timely and safe transportation between care settings of patients, who are near their end of life. Commissioning of services should be responsive to the complexities of patients' needs and those of their families.Citation
Ingleton, C., Payne, S., Sargeant, A. and Seymour, J. (2009) Barriers to achieving care at home at the end of life: transferring patients between care settings using patient transport services. Palliat Med, 23 (8), 723-30.Link to publisher’s version
http://dx.doi.org/10.1177/0269216309106893Type
articleCollections
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