Barriers and facilitators to the implementation of a paediatric palliative care team

Abstract

BackgroundOver the last decade, paediatric palliative care teams (PPCTs) have been introduced to support children with life-limiting diseases and their families and to ensure continuity, coordination and quality of paediatric palliative care (PPC). However, implementing a PPCT into an organisation is a challenge. The objective of this study was to identify barriers and facilitators reported by healthcare professionals (HCPs) in primary, secondary or tertiary care for implementing a newly initiated multidisciplinary PPCT to bridge the gap between hospital and home.MethodsThe Measurement Instrument for Determinants of Innovations (MIDI) was used to assess responses of 71 HCPs providing PPC to one or more of the 129 children included in a pilot study of a PPCT based at a university children’s hospital. The MIDI (29 items) assessed barriers and facilitators to implementing the PPCT by using a 5-point scale (completely disagree to completely agree) and additional open-ended questions. Items to which ≥20% of participants responded with ‘totally disagree/disagree’ and ≥80% responded with ‘agree/totally agree’ were considered as barriers and facilitators, respectively. A general inductive approach was used for open-ended questions.ResultsReported barriers to implementing a PPCT were related to the HCP’s own organisation (e.g., no working arrangements related to use of the intervention [PPCT] registered, other organisational changes such as merger going on). Reported facilitators were mainly related to the intervention (correctness, simplicity, observability and relevancy) and the user scale (positive outcome expectations, patient satisfaction) and only once to the organisation scale (information accessibility). Additionally, HCPs expressed the need for clarity about tasks of the PPCT and reported having made a transition from feeling threatened by the PPCT to satisfaction about the PPCT.ConclusionPositive experiences with the PPCT are a major facilitator for implementing a PPCT. Tailored organisational strategies such as working arrangements by management, concrete information about the PPCT itself and the type of support provided by the PPCT should be clearly communicated to involved HCPs to increase awareness about benefits of the PPCT and ensure a successful implementation. New PPCTs need protection and resources in their initial year to develop into experienced and qualified PPCTs.Electronic supplementary materialThe online version of this article (10.1186/s12904-018-0274-8) contains supplementary material, which is available to authorized users.

Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study

“…The Statistical Package for Social Sciences 21.0 was used for data analysis. In line with Verberne, Kars, Schepers, Schouten-van Meeteren, Grootenhuis, and van Delden [49], we defined MIDI items to which ≥20% of participants responded 'totally disagree/disagree' as barriers and items to which ≥80% of participants responded 'agree/totally agree' as facilitators for implementing the WNCS. Descriptive statistics (mean, standard deviation, median, range and percentage) were applied to the participant characteristics and MIDI scores.…”

Implementation of Sustainable Complex Interventions in Health Care Services: The Triple C Model

“…Barriers and facilitators of complex interventions in health services Several factors have been identi ed in the literature as barriers and facilitators for implementing complex interventions as shown in Table 1 [39][40][41][42][43][44][45][46][47][48][49][50][51]. Common barriers across the studies included: education and training needs of staff, lack of leadership support, time constraints, complexity of intervention, lack of staff engagement and poor management and communication.…”

Advancing Pediatric Palliative Care In A Low-Middle Income Country: A Descriptive Analysis of the Implementation, A challenging But Not Impossible Task

“…This multidisciplinary team designed exclusive approaches for the pediatric population that provided coordination and support to the attending healthcare professionals during hospitalization, clinical decision-making, accompaniment throughout the patients' disease trajectory, around-the-clock availability, activities that seek to promote quality of life, workshops for bereaved parents (24), among others that will be described later.…”