A qualitative exploration of interactional and organizational determinants of collaboration in cancer palliative care settings: Family members’, health care professionals’ and key informants’ perspectives

Abstract

As life expectancy has increased, a growing number of people experience conditions, including cancers, that carry complex health and social needs. Palliative care services have the potential to address these needs but face significant obstacles. One major obstacle is suboptimal interprofessional collaboration. This study’s goal was an in-depth exploration of interactional and organizational barriers and supports of collaboration in palliative care in Switzerland. We sought the perspectives of health care professionals, patients’ family members and leaders and experts in oncology/palliative care delivery (key informants) through interviews and focus groups with fifty HPs and key informants and ten patients’ family members. Qualitative analyses of interviews and focus groups used framework analysis. We identified three major themes of interaction: personal characteristics, communication, and connectedness with other health care professionals; and three major organizational themes: service characteristics, standardized communication and processes, and service coordination and promotion. Based on our findings, we recommend that health care professionals consider strategies to increase their collaboration and communication skills and opportunities to interact. We advocate the implementation of methods for coordinating services, standardization of consultation/referral procedures and communication between health care professionals, and the promotion of underutilized services to foster successful, sustainable collaboration.

Barriers and facilitators to national guideline implementation for palliative cancer care in a Danish cross‐sectoral healthcare setting: A qualitative study of healthcare professionals' experiences

“…The lack of collaboration, coordination, and communication between sectors and within individual sectors has repeatedly been identified as a barrier to palliative care. 7,8 A Norwegian study identified three main barriers experienced by district nurses and GPs. 9 The first was the lack of an initial interdisciplinary meeting to ensure coordination of palliative care.…”

“…The Danish NG on palliative care recommends systematic needs assessment, planning and initiation of services based on patient needs, collaboration across healthcare sectors and between general and specialised palliative care providers such as the hospital department, municipalities, and patients' general practitioners (GPs), implementation, and follow‐up 4 (Appendix). The lack of collaboration, coordination, and communication between sectors and within individual sectors has repeatedly been identified as a barrier to palliative care 7,8 . A Norwegian study identified three main barriers experienced by district nurses and GPs 9 .…”