Experience and Views of Oncology and Palliative Care Professionals on a Corounding Model of Care for Inpatients With Advanced Cancer

Am J Hosp Palliat Care. 2018 Nov;35(11):1433-1438. doi: 10.1177/1049909118778863. Epub 2018 May 29.

Abstract

Background: Palliative care is associated with better outcomes in advanced cancer, but there is limited research comparing different models of palliative care delivery alongside oncology care. For inpatients with cancer, palliative care is mostly delivered through a consult service, primarily relying on oncologist-initiated referrals to a separate specialist palliative care team. In our hospital setting, we piloted a palliative care and oncology corounding model of care.

Aim: To explore the views and experience of oncology and palliative care professionals on the corounding model compared to an inpatient consult service.

Design: A qualitative study nested within a pre-post study of the corounding model of care, with semistructured interviews using thematic analysis.

Setting/participants: Eleven doctors and nurses involved in the pilot corounding model were interviewed.

Results: Two main themes emerged: (1) the efficiency of care delivery and (2) quality of patient care. The theme on the efficiency of care delivery was related to access to palliative care input, team communications, and parallel workflow. The quality of patient care was described in terms of holistic approach to cancer care and rapport building with patients and their families. Most participants acknowledged positive aspects of the corounding model, yet some minor concerns were reported, such as disagreements between oncology and palliative care professionals.

Conclusions: This study provides insights into the benefits and drawbacks of a corounding model of care for inpatients. The views of health-care professionals can be incorporated into the development of integrated oncology and palliative care models to improve care for patients with advanced cancer.

Keywords: delivery of health care; health services research; hospital oncology service; medical oncology; palliative care; qualitative research.

MeSH terms

  • Attitude of Health Personnel
  • Communication
  • Efficiency, Organizational
  • Health Personnel / psychology*
  • Holistic Health
  • Humans
  • Interviews as Topic
  • Medical Oncology / organization & administration*
  • Neoplasms / therapy*
  • Palliative Care / organization & administration*
  • Patient Care Team / organization & administration
  • Qualitative Research
  • Quality of Health Care / organization & administration