What are the views of hospital-based generalist palliative care professionals on what facilitates or hinders collaboration with in-patient specialist palliative care teams? A systematically constructed narrative synthesis

Firn, Janice; Preston, Nancy; Walshe, Catherine

doi:10.1177/0269216315615483

Cited by 71 publications

(88 citation statements)

References 73 publications

(541 reference statements)

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“…A study of community palliative care nurse and physician providers found that developing strong relationships facilitates perceptions of cohesion and contributes to wards’ ability to do their own work, this study confirms similar patterns of relating occur in the inpatient setting with social workers as well [49]. Additionally, similar to previous studies, relationships and collaboration were enhanced by co-location [12, 21, 49, 50]. The similarities between these results and existing knowledge, which primarily stems from studies of nurses and physicians, are noteworthy.…”

Section: Discussionsupporting

confidence: 86%

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Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

Firn

Preston²,

Walshe³

2017

BMC Palliat Care

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BackgroundInpatient, generalist social workers in discharge planning roles work alongside specialist palliative care social workers to care for patients, often resulting in two social workers being concurrently involved in the same patient’s care. Previous studies identifying components of effective collaboration, which impacts patient outcomes, care efficiency, professional job satisfaction, and healthcare costs, were conducted with nurses and physicians but not social workers. This study explores ward social workers’ perceptions of what facilitates or hinders collaboration with palliative care social workers.MethodsGrounded theory was used to explore the research aim. In-depth qualitative interviews with masters trained ward social workers (n = 14) working in six hospitals located in the Midwest, United States were conducted between February 2014 and January 2015. A theoretical model of ward social workers’ collaboration with palliative care social workers was developed.ResultsThe emerging model of collaboration consists of: 1) trust, which is comprised of a) ability, b) benevolence, and c) integrity, 2) information sharing, and 3) role negotiation. Effective collaboration occurs when all elements of the model are present.ConclusionCollaboration is facilitated when ward social workers’ perceptions of trust are high, pertinent information is communicated in a time-sensitive manner, and a flexible approach to roles is taken. The theoretical model of collaboration can inform organisational policy and social work clinical practice guidelines, and may be of use to other healthcare professionals, as improvements in collaboration among healthcare providers may have a positive impact on patient outcomes.

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Section: Discussionsupporting

confidence: 86%

“…For social work collaboration to be successful it is important to understand what social workers view as collaborative. Very little is known about ward social workers’ perceptions of collaborating with palliative care social workers [20, 21]. …”

Section: Introductionmentioning

confidence: 99%

Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

Firn

Preston²,

Walshe³

2017

BMC Palliat Care

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“…Nurses are in a pivotal position to strengthen partnership working between providers across range of care settings, with positive outcomes for patients (Firn et al, 2016). However, nursing needs to continue to adapt and respond to the changing needs of the patients and their families in a rapidly changing healthcare environment.…”

Section: Resultsmentioning

confidence: 99%

“…However, the split between generalist and specialist palliative care can be problematic, with continuing debate about remit, roles and boundaries (Firn et al, 2016) (Gardiner et al, 2012). Although specialists in palliative care may be well positioned to manage patients with the most complex needs, there is a risk in specialists being called upon to see all patients with palliative care needs.…”

Section: Nursing and Palliative Care: A Critical Reflectionmentioning

confidence: 99%

Specialist palliative care nursing and the philosophy of palliative care: a critical discussion

et al. 2017

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Nursing is the largest regulated health professional workforce providing palliative care across a range of clinical settings. Historically, palliative care nursing has been informed by a strong philosophy of care which is soundly articulated in palliative care policy, research and practice. Indeed, palliative care is now considered to be an integral component of nursing practice regardless of the specialty or clinical setting. However, there has been a change in the way palliative care is provided. Upstreaming and mainstreaming of palliative care and the dominance of a biomedical model with increasing medicalisation and specialisation are key factors in the evolution of contemporary palliative care and are likely to impact on nursing practice. Using a critical reflection of the authors own experiences and supported by literature and theory from seminal texts and contemporary academic, policy and clinical literature, this discussion paper will explore the influence of philosophy on nursing knowledge and theory in the context of an evolving model of palliative care.

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“…As identified by participants here and elsewhere, inpatient social workers frequently learn palliative skills through observation and collaboration with specialist-level palliative social work colleagues (Sumser, Remke, Leimena, Altilio, & Otis-Green, 2015). Inpatient social workers HOSPITAL SOCIAL WORK GENERALIST PALLIATIVE SKILLS 20 with no prior palliative-related education at hospitals without a dedicated specialist-level palliative social worker could lack the necessary proximity for learning generalist-level palliative social work skills (Firn et al, 2016). Finally, institutional value for cycling patients through the hospital quickly, and inpatient social workers part in accomplishing that goal, could drive hiring practices and define social work scope of practice (Chan, Farias, Bambos, & Escobar, 2011;Lee et al, 2014;Lovett, Illg, & Sweeney, 2016).…”

Section: Education Practice and Research Implicationsmentioning

confidence: 99%

Hospital-based social workers’ perceptions of generalist- and specialist-level palliative social work activities

Firn

Preston

Walshe

2020

Journal of Social Work

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A social work advisory group recently proposed 41 generalist-level palliative social work activities applicable to any venue, including hospital-based social work, but this applicability has not been empirically tested. Therefore, we used critical realist grounded theory analysis of qualitative interviews to explore whether the activities proposed by the advisory group reflect inpatient social workers' perceptions of their generalist-level palliative activities when caring for patients alongside specialist-level palliative social workers. Fourteen Masters educated social workers from six hospitals in the Midwest United States participated.Corresponding concepts from interview data of hospital-based social workers' perceptions of what facilitates or hinders collaboration with specialist-level palliative social workers were identified and mapped onto the 41 generalist-level palliative social work activities. We used NVivo to organize and track data. Findings: Inpatient social workers find it challenging to engage in specific generalist-level palliative social work activities; provision of generalist-level palliative services is shaped by discharge planning duties, the consultation model, and the concentrated role of specialist-level palliative social workers. Competency in cultural and spiritual aspects of care could be lacking. Applications: Most of the 41 generalist-level palliative social work activities are present in hospital-based social workers' clinical practice. However, not all activities may be applicable or realizable in the inpatient venue. In the hospital, an emphasis on discharge planning and related time-barriers can mean seriously-ill patients and their families lack access to generalist-level palliative social work services. Clarification is needed about which of the 41 activities are relevant to and actionable within the inpatient venue.

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What are the views of hospital-based generalist palliative care professionals on what facilitates or hinders collaboration with in-patient specialist palliative care teams? A systematically constructed narrative synthesis

Cited by 71 publications

References 73 publications

Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

Specialist palliative care nursing and the philosophy of palliative care: a critical discussion

Hospital-based social workers’ perceptions of generalist- and specialist-level palliative social work activities

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