Perceptions of Palliative Care Program Viability During the Pandemic: Qualitative Results From a National Survey

Abstract

Background: Palliative care programs have played a significant role during the COVID-19 pandemic. However, the financial impact of the pandemic and operational challenges for palliative care programs have raised concerns for their future viability. Objectives: To explore palliative care program leaders’ perceptions of the future viability of their programs in the context of the pandemic and inform future educational and program development. Methods: Surveys were sent to 1430 specialist palliative care program leaders, identified through the Center to Advance Palliative Care’s contact lists, via email in May 2020 and January 2021. Leaders were asked why they were or were not concerned about the viability of their palliative care programs. Qualitative content analysis was applied to determine themes. Results: We received 440 responses. Most programs served hospital settings and were geographically located across all US regions. We identified four themes: 1) The importance of being valued by organizational leadership and peers, 2) The importance of adequate and supported palliative care staff, 3) The pandemic validated and accelerated the need for palliative care, and 4) The pandemic perpetuated organizational financial concerns. Conclusion: Findings provide insights about palliative care program viability from the perspective of program leaders during a global pandemic. Technical assistance to support palliative care teams and their relationships with stakeholders, methods to measure the impact of peer support, efforts to educate administrators about the value of palliative care, and efforts to reduce burnout are needed to sustain palliative care programs into the future.

HPNA Value Statement

“…5 The COVID-19 pandemic highlighted the need for (1) the expansion of and equitable access to palliative care services for patients, families, and communities, especially minoritized populations; (2) frequent conversations about death, dying, and coping with loss; (3) expert symptom management; and (4) attention to the health of the nursing workforce. [6][7][8] Palliative and hospice nurses play an instrumental role in mentoring and educating fellow nurses and interprofessional colleagues in primary palliative care. As such, the inclusion of palliative care education in undergraduate and graduate nursing programs is now outlined in the American Association of Colleges of Nursing Essentials: Core Competencies of Professional Nursing Education.…”