title: Physicians' interactions with health care teams and systems in the care of dying patients: perspectives of dying patients, family members, and health care professionals.
abstract: This study investigated the specific physician skills required to interact with health care systems in order to provide high quality care at the end of life. We used focus groups of patients with terminal diseases, family members, nurses and social workers from hospice or acute care settings, and physicians. We performed content analysis based on grounded theory. Groups were interviewed. Two domains were found related to physician interactions with health care systems: 1) access and continuity, and 2) team communication and coordination. Components of these domains most frequently mentioned included taking as much time as needed with the patient, accessibility, and respect shown in working with health team members. This study highlights the need for both physicians and health care systems to improve accessibility for patients and families and increase coordination of efforts between health care team members when working with dying patients and their families.
authors.affiliation: Department of Medical Education and Biomedical Informatics, University of Washington, Seattle, WA 98195, USA.
authors.forename: Jan D
authors.initials: JD
authors.lastname: Carline
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
authors.forename: Marjorie D
authors.initials: MD
authors.lastname: Wenrich
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Shannon
authors.forename: Donna M
authors.initials: DM
authors.lastname: Ambrozy
authors.forename: Paul G
authors.initials: PG
authors.lastname: Ramsey
mesh_terms: D003695:Delivery of Health Care; D005190:Family; D006282:Health Personnel; D006801:Humans; D010348:Patient Care Team; D010361:Patients; D010820:Physicians; D013727:Terminal Care