Purpose The purpose of this paper is to propose a unified definition of integrated palliative care (IPC), and to identify the elements that facilitate or hinder implementation of an integrated palliative care system (IPCS). Design/methodology/approach A scoping review of the conceptualization and essential elements of IPC was undertaken, based on a search of the PubMed, Scopus and ISI Web of Science databases. The search identified 79 unduplicated articles; 43 articles were selected for content analysis. Findings IPC is coordinated and collaborative across different health organizations, levels of care and types of providers. Eight key elements facilitate implementation of an IPCS: coordination, early patient identification, patient-centered services, care continuity, provider education and training, a standard implementation model and screening tool, shared information technology system, and supportive policies and funding. These elements were plotted as a “Circle of Integrated Palliative Care System Elements.” Practical implications This paper offers researchers an inclusive definition of IPC and describes the essential elements of its successful implementation. Originality/value This study provides evidence from researchers on five continents, offering insights from multiple countries and cultures on the topic of IPC. The findings of this thematic analysis could assist international researchers aiming to develop a standard evaluative model or assess the level of integration in a health care system’s delivery of palliative care.

PurposeResearch findings provide the professional community with knowledge that enables to better understand healthcare interventions. Many authors point out that whilst these findings are valued, the findings are not always translated into healthcare practise. The purpose of the paper is to assess the applicability of the essential elements of an integrated palliative care system (IPCS) found in research into the practise of Osona Palliative Care System (OPCS).Design/methodology/approachThe study used a qualitative methodology with a case study design. In total, 24 health professionals were interviewed in Osona for the research, and the results were analysed using deductive content analysis.FindingsThe study concludes that research findings can better be translated into specific contexts by incorporating the needs and characteristics of the system. The process could be a strategy for bridging the research–practise gap.Originality/valueCombining the findings from the study and the findings found in the literature reviewed led to the creation of the IPCS-elements-blended model of research and practise. Such a kind of mixed model could be used in other studies seeking to overcome the research and practice gap.

BACKGROUND The aging population in the Global North is associated with an increased prevalence of multiple chronic diseases that would benefit from Integrated Palliative Care (IPC) 1. Often, the elderly reside in rural areas that lack access to comprehensive healthcare services. Therefore, it is vital to consider the effectiveness of healthcare systems and their ability to respond to the healthcare needs of this population, including access to palliative care (PC) services. Understanding palliative care program availability, care access, and Palliative Care Systems (PCS) characteristics are important to create useful health interventions in rural areas. OBJECTIVE This study aims to provide an international view of chronic health issues that the elderly face. This study will compare two culturally and geographically different PCS's, one in Osona, Catalonia, Spain, and the second in Southern Minnesota, United States. METHODS This study will be performed using qualitative case study methodology. The initial phase consisted of a literature search to identify a framework for describing Integrated Palliative Care Systems (IPCS) 2. In the second phase, a medium-sized rural area in Southern Minnesota will be compared with a similarly sized rural area in Catalonia, Spain. Finally, critical providers in PCS and IPCS will be identified and invited to participate in semi-structured interviews. These interviews will focus on the perceived gap between ideal IPCS care services with existing PCS/IPCS services. In addition, the participants will be asked about their perceptions of ethical issues and dilemmas that evolved during the COVID-19 pandemic. RESULTS Timeline: After an ethical review of this protocol, data collection is anticipated to begin in the spring of 2022 and is expected to take six months. Data collection will be followed by data analysis in fall 2022. Finally, the researchers plan to disseminate the findings in the spring of 2023. CONCLUSIONS Conclusions: Studying two similarly sized but culturally and geographically different rural PCS's will give insights into how IPCS impacts the chronically ill and elderly. This study findings will contribute to enhanced patient care, organizational improvements, policy change, and understanding the impact of different healthcare system models. In addition, new patient-centered care strategies will be identified by understanding the ethical dilemmas encountered by PCS healthcare providers. CLINICALTRIAL Not applicable

Background The aging population in the Global North is associated with an increased prevalence of multiple chronic diseases that would benefit from integrated palliative care. In this context, it is vital to consider the effectiveness of health care systems’ response to the needs of the older population residing in rural areas, including access to palliative care services. Understanding palliative care program availability and palliative care system characteristics is important in creating useful health interventions in rural areas. Objective This study aims to provide an international view on palliative care in rural areas. A study exploring palliative care services offered in Southern Minnesota will be carried out, building on a previous study conducted in Osona, Spain. Findings from both studies will be compared, providing insights into the strengths of each system and identifying areas for growth. Methods This study will be performed using qualitative case study methodology. Using a similar methodology to the one used in the Spanish study, palliative care services will be explored in a similarly sized rural area in Southern Minnesota. This will be accomplished by (1) reviewing available literature related to the Southern Minnesota palliative care system and (2) identifying key providers in this US palliative care system who will be invited to participate in semistructured interviews. The study participants will be asked about the gaps between ideal integrated palliative care system services and the existing complementary palliative care services, and the ethical issues and dilemmas that evolved during the COVID-19 pandemic. Results Following ethical approval for this protocol, data collection is anticipated to begin in spring or summer 2022 and is expected to take 6 months. Data collection will be followed by data analysis in fall 2022. Finally, the researchers plan to disseminate the findings in spring 2023. Conclusions Comparing 2 similarly sized but culturally different rural palliative care systems in Minnesota and Osona will provide insights into how integrated palliative care systems impact the older population and those with chronic illnesses. Study findings will contribute to enhanced patient care, organizational improvements, policy change, and an understanding of the impact of different health care system models. International Registered Report Identifier (IRRID) PRR1-10.2196/36037