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BackgroundResearch is essential to improving outcomes for patients with life-threatening illness and it is vital that hospices are at the centre of this (Payne, Preston, Turner et al, 2013). Journal clubs have been identified as a way of sharing evidence amongst hospice teams, developing staff research skills and contributing to hospice research culture but they are not widespread in hospices, with barriers often encountered in their development and sustainability (Turner & Payne, 2019. Eur J Palliat Care. 19:34).AimsThis project aims to develop a toolkit to support hospices in establishing and sustaining multidisciplinary journal clubs.MethodsAt Marie Curie Hospice, Liverpool, a new model of journal club was implemented in January 2019 with a focus on promoting reflection of the relevance of research to clinical practice (Steele, Stanley & Nwosu, 2019. BMJ Support Palliat Care. 9:A50). Attendance, and contributions to presenting, come from across the multidisciplinary team and palliative care service sites in the locality. A toolkit to allow this to be replicated was developed by the research team, informed by participant feedback and the successes and challenges of setting up the journal club from scratch then surviving, growing and thriving in a semi-virtual model despite the COVID-19 pandemic (Stanley, Nwosu & Finney, 2021. BMJ Support Palliat Care. 11:A4).ResultsThe toolkit consists of a practical guide to both setting up and running the journal club, with flexibility to be individualised to diverse hospices across the UK. In addition, it includes resources such as presenter templates and certificates. The toolkit is being piloted in two palliative care centres so that facilitators and barriers to its use can be identified.ConclusionsThis work will lead to the development of a freely available toolkit that any hospice can use to support their implementation of a journal club, thus promoting a research culture and evidence-based practice.
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BACKGROUND: Developments in digital health have the potential to transform the delivery of health and social care to help citizens manage their health. Currently, there is a lack of consensus about digital health research priorities in palliative care and a lack of theories about how these technologies might improve care outcomes. Therefore, it is important for health care leaders to identify innovations to ensure that an increasingly frail population has appropriate access to palliative care services. Consequently, it is important to articulate research priorities as the first step in determining how finite resources should be allocated to a field saturated with rapidly developing innovation. OBJECTIVE: The aim of this study is to identify research priority areas for digital health in palliative care. METHODS: We selected digital health trends, most relevant to palliative care, from a list of emerging trends reported by a leading institute of quantitative futurists. We conducted 2 rounds of the Delphi questionnaire, followed by a consensus meeting and public engagement workshop to establish a final consensus on research priorities for digital technology in palliative care. We used the views of public representatives to gain their perspectives on the agreed priorities. RESULTS: A total of 103 experts (representing 11 countries) participated in the first Delphi round. Of the 103 experts, 55 (53.3%) participated in the second round. The final consensus meetings were attended by 10.7% (11/103) of the experts. We identified 16 priority areas, which involved many applications of technologies, including care for patients and caregivers, self-management and reporting of diseases, education and training, communication, care coordination, and research methodology. We summarized the priority areas into eight topics: big data, mobile devices, telehealth and telemedicine, virtual reality, artificial intelligence, smart home, biotechnology, and digital legacy. CONCLUSIONS: The priorities identified in this study represent a wide range of important emerging areas in the fields of digital health, personalized medicine, and data science. Human-centered design and robust governance systems should be considered in future research. It is important that the risks of using these technologies in palliative care are properly addressed to ensure that these tools are used meaningfully, wisely, and safely and do not cause unintentional harm.
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IntroductionThe need for palliative care is expected to increase globally due to a number of socioeconomic factors,1 therefore it is essential for society to use technology better to improve palliative care.2AimsThis project looks to identify learning beyond the COVID19 pandemic in the United Kingdom (UK), highlighting knowledge and skills required to support healthcare professionals to adopt technology to support communication.MethodAn electronic survey was developed consisting of a maximum of 36 multiple choice and free text response questions gathering demographic information and covering three themed areas: Communication within the multidisciplinary team, use of technology for education and using technology to support communication with patients and carers.ResultsThe survey received 234 responses from palliative care healthcare professionals across the UK, with 97% of respondents reporting that they have used technology to support communication more since the beginning of the Covid19 pandemic. Responses have highlighted several benefits of using technology to support communication in these areas, whilst providing greater understanding of the barriers that exist.ConclusionOur work has shown that there is an increasing use of technology to support communication in palliative care. It is essential that organisations acknowledge and adapt to this change in order for healthcare professionals to provide the best possible care by improving access and quality of palliative care services.ImpactThis work highlights areas of improvement needed to allow healthcare professionals to use technology to support communication. If used well, this can improve the scope of palliative care delivery in the future.References Bone AE, Gomes B, Etkind SN, et al. What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death. Palliative Medicine 2017;32(2):329–36. doi:10.1177/0269216317734435 Nwosu AC, Collins B, Mason S. Big data analysis to improve care for people living with serious illness: the potential to use new emerging technology in palliative care. Palliative Medicine 2018;32(1):164–66. doi:10.1177/0269216317726250
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BackgroundMany palliative care organisations use journal clubs to support educational development for staff. However, to date, the potential to use journal clubs to directly improve clinical care in hospices (through quality improvement activity) has not been described in the literature.AimsWe describe the development of a multidisciplinary hospice journal club, through which aimed to (1) develop research questions to clinical care problems in the hospice and (2) identify solutions to these problems to improve care delivery.MethodsIn January 2019, we established fortnightly journal club meetings, which provided staff with the opportunity to present hospice-relevant palliative care research. In these meetings, we discussed the main findings, clinical practice implications and future research questions. Initially, the meetings were in-person, but we later hosted these online (via Microsoft Teams) due to the COVID-19 pandemic, which enabled virtual participation. We used the research questions generated to inform future quality improvement work. We asked staff to complete a feedback survey to determine their views of the process.ResultsWe have conducted 30 journal club meetings, which have generated 124 research questions. Thirteen meetings were virtual. We have conducted quality improvement work using these research questions to improve clinical care. Nineteen staff (representing five clinical sites) completed feedback. The feedback was positive, with participants stating that the journal club was educational, clinically relevant and enjoyable. The main problem identified by participants were technological issues relating to participating in the virtual meetings.Conclusion/DiscussionWe have demonstrated how a palliative care journal club can be used to improve clinical care in a hospice. Our experience can be used by other palliative care settings to engage staff in research and improve care for those with serious illness.