Formative evaluation of a multi-component, education-based intervention to improve processes of end-of-life care.
A multicomponent, palliative care, education-based intervention was implemented in six Veterans Affairs Medical Centers in the southeast United States. The intervention comprised onsite staff training plus supporting written materials, installation of an electronic order set, and follow-up consultations. Training included large-group didactic presentations, small-group clinical demonstrations, and one-on-one consultations. The intervention strategy was targeted broadly to hundreds of hospital providers, including physician, nursing, and ancillary staff. The purpose was to train staff in identifying actively dying patients and implementing best practices of home-based hospice care. A formative evaluation was conducted utilizing semistructured telephone interviews with key informants from each site. Qualitative data analysis revealed processes that facilitated or impeded uptake of the intervention. Results will be used to inform ongoing and future clinical initiatives and optimize future implementation of education-based interventions to improve adoption of best practices for end-of-life care within acute care settings.
a Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs , Birmingham VA Medical Center; and School of Medicine, University of Alabama at Birmingham , Birmingham , Alabama , USA.
Beverly R
BR
Williams
Lesa L
LL
Woodby
F Amos
FA
Bailey
Kathryn L
KL
Burgio
D002985:Clinical Protocols; D020000:Decision Support Systems, Clinical; D005853:Geriatrics / Q000193:education*; D017051:Hospice Care / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D007857:Leadership; D010043:Outcome and Process Assessment, Health Care; D010564:Personnel, Hospital / Q000193:education*; D057766:Policy; D011787:Quality of Health Care; D013727:Terminal Care / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs