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Nationwide strategies employed to provide and integrate palliative care to patients with covid-19
Palliative Medicine ; 35(1 SUPPL):216-217, 2021.
Article in English | EMBASE | ID: covidwho-1477141
ABSTRACT

Background:

Little is known on what palliative care (PC) has been provided to patients with COVID-19.

Aims:

To understand what PC was provided nationwide to patients with COVID-19 and strategies implemented to overcome barriers during the pandemic.

Methods:

Semi-structured interviews were conducted with physicians across Canada about their experiences providing PC to patients with COVID-19. Thematic analysis was used to describe and interpret overarching themes.

Results:

Twelve specialized PC (SPC) and 11 primary PC (PPC) were interviewed. Interim analysis of 16 coded interviews demonstrated SPC and PPC physicians used traditional strategies (such as opioids, oxygen and serious illness conversations) to manage symptoms, support end of life, and engage patients and families in goals of care conversations (GOC). Neither SPC nor PPC indicated strong adoption of GOC and symptom management tools circulated early in the pandemic. Both SPC and PPC indicated a shift to virtual communication due to restrictive visitor policies, highlighting the need for distanced support and planned communication. Care coordination for PC patients was challenged by a lack of community resources, family infected with COVID-19, prolonged hospital stays, and increased number of PC patients discharged to rehabilitation services. New PC structures included;GOC teams that functioned in the emergency department and medicine floors, integrated clinical rounding by non-PC clinicians with PC teams, and hospital-based PC outreach to long term care. Strategies to improve PC implementation included virtual technologies, team collaboration, patient and family engagement tools, and symptom management and GOC conversations tools.

Conclusions:

While PC management approaches to support patients with COVID-19 were mostly unchanged, new structures and strategies were developed to ensure patients and their families were provided with support.

Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Palliative Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Palliative Medicine Year: 2021 Document Type: Article