An evaluation of the impact of the Gold Standards Framework on collaboration in end-of-life care in nursing homes. A qualitative and quantitative evaluation

Badger, Frances; Plumridge, Gillian; Hewison, Alistair; Shaw, Karen L.; Kirste, Thomas; Clifford, Collette

doi:10.1016/j.ijnurstu.2011.10.021

Cited by 62 publications

(79 citation statements)

References 28 publications

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“…32,33 Effective collaboration between these two groups can be mutually beneficial as it allows the team to achieve goals not otherwise possible by providing opportunities for accessing resources and services that are integrated for the specific benefit of the patient. 10,11,19,34,35 …”

Section: Interdisciplinary Collaboration and Holismmentioning

confidence: 99%

The role of the keyworker in breaking down professional culture barriers to providing high-quality palliative care: a literature review

Feuz

2013

J Radiother Pract

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Background: Palliative cancer care is by definition multi-professional in nature. An interdisciplinary approach to disease management emphasising continuity of care results in increased quality of life for patients and families. Complex disease management demands the provision of a full spectrum of high-quality care; requiring both specialist and generalist services. Appointed keyworkers are knowledgeable about patient preferences enabling effective coordination of care and promotes collaborative team-working. The need for diversity in the provision of palliative care is recommended but can challenge effective interdisciplinary collaboration by creating tension and limiting the interdisciplinary team (IDT) from reaching its full potential resulting in adverse outcomes.

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Section: Interdisciplinary Collaboration and Holismmentioning

confidence: 99%

The role of the keyworker in breaking down professional culture barriers to providing high-quality palliative care: a literature review

Feuz

2013

J Radiother Pract

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“…Drawing on models such as the Gold Standards Framework in Care Homes (GFSCH)36 in the UK, and the residential aged care integration programme (RACIP)37 study (involving gerontology ARC outreach) in New Zealand, as well as results from the present study, the new model includes clinical coaching, and role modelling of both elements are shown to be successful in sustaining knowledge transfer 38. Staff in the current study indicated difficulty identifying when a palliative approach should be initiated.…”

Section: Discussionmentioning

confidence: 99%

Necessary but not yet sufficient: a survey of aged residential care staff perceptions of palliative care communication, education and delivery

Frey

Boyd

Foster

et al. 2016

BMJ Support Palliat Care

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“…AI did not preclude the use and refinement of existing Advance Care Plans, end-of-life care frameworks and extra training in end-of-life care, all of which aim to address the same issues. [238][239][240] AI led to their increased use (DNACPR, palliative care register, LCP 215 ). However, its context-specific, non-hierarchical approach to co-design was arguably more flexible and better suited to working across organisations and between public and independent providers.…”

Section: Summary and Discussion Of Phase 2 Findingsmentioning

confidence: 99%

Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM)

Iliffe

Wilcock

Drennan

et al. 2015

Programme Grants for Applied Research

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BackgroundThe needs of people with dementia and their carers are inadequately addressed at all key points in the illness trajectory, from diagnosis through to end-of-life care. The EVIDEM (Evidence-based Interventions in Dementia) research and development programme (2007–12) was designed to help change this situation within real-life settings.ObjectivesThe EVIDEM projects were (1) evaluation of an educational package designed to enhance general practitioners’ (GPs’) diagnostic and management skills; (2) evaluation of exercise as therapy for behavioural and psychological symptoms of dementia (BPSD); (3) development of a toolkit for managing incontinence in people with dementia living at home; (4) development of a toolkit for palliative care for people with dementia; and (5) development of practice guidance on the use of the Mental Capacity Act (MCA) 2005.DesignMixed quantitative and qualitative methods from case studies to large database analyses, including longitudinal surveys, randomised controlled trials and research register development, with patient and public involvement built into all projects.SettingGeneral practices, community services, third-sector organisations and care homes in the area of the North Thames Dementia and Neurodegenerative Diseases Research Network local research network.ParticipantsPeople with dementia, their family and professional carers, GPs and community mental health team members, staff in local authority social services and third-sector bodies, and care home staff.Main outcome measuresDementia management reviews and case identification in general practice; changes in behavioural and psychological symptoms measured with the Neuropsychiatric Inventory (NPI); extent and impact of incontinence in community-dwelling people with dementia; mapping of pathways to death of people with dementia in care homes, and testing of a model of collaborative working between primary care and care homes; and understandings of the MCA 2005 among practitioners working with people with dementia.ResultsAn educational intervention in general practice did not alter management or case identification. Exercise as a therapy for BPSD did not reduce NPI scores significantly, but had a significant positive effect on carer burden. Incontinence is twice as common in community-dwelling people with dementia than their peers, and is a hidden taboo within a stigma. Distinct trajectories of dying were identified (anticipated, unexpected and uncertain), and collaboration between NHS primary care and care homes was improved, with cost savings. The MCA 2005 legislation provided a useful working framework for practitioners working with people with dementia.ConclusionsA tailored educational intervention for general practice does not change practice, even when incentives, policy pressure and consumer demand create a favourable environment for change; exercise has potential as a therapy for BPSD and deserves further investigation; incontinence is a common but unrecognised problem for people with dementia in the community; changes in relationships between care homes and general practice can be achieved, with benefits for people with dementia at the end of life and for the UK NHS; application of the MCA 2005 will continue to improve but educational reinforcements will help this. Increased research capacity in dementia in the community was achieved. This study suggests that further work is required to enhance clinical practice around dementia in general practice; investigate the apparent beneficial effect of physical activity on BPSD and carer well-being; develop case-finding methods for incontinence in people with dementia; optimise working relationships between NHS staff and care homes; and reinforce practitioner understanding of the MCA 2005.Trial registrationEVIDEM: ED-NCT00866099; EVIDEM: E-ISRCTN01423159.FundingThis project was funded by the Programme Grants for Applied Research programme of the National Institute for Health Research.

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An evaluation of the impact of the Gold Standards Framework on collaboration in end-of-life care in nursing homes. A qualitative and quantitative evaluation

Cited by 62 publications

References 28 publications

The role of the keyworker in breaking down professional culture barriers to providing high-quality palliative care: a literature review

The role of the keyworker in breaking down professional culture barriers to providing high-quality palliative care: a literature review

Necessary but not yet sufficient: a survey of aged residential care staff perceptions of palliative care communication, education and delivery

Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM)

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