No ordinary consultation – a qualitative inquiry of hospital palliative care consultation services
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 3 August 2020
Issue publication date: 15 September 2020
Abstract
Purpose
Considering the great need for palliative care in hospitals, it is essential for hospital staff to have palliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care. However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need for further knowledge about the process of palliative consultations. The purpose of this study therefore was to examine how palliative consultations in hospitals are practised, as perceived by consultants and health care professionals on receiving wards.
Design/methodology/approach
Focus groups with palliative care consultation services, health care personnel from receiving wards and managers of consultation services. Interpretive description and constant comparative method guided the analysis.
Findings
Variations were seen in several aspects of practice, including approach to practice and represented professions. The palliative consultants were perceived to contribute by creating space for palliative care, adding palliative knowledge and approach, enhancing cooperation and creating opportunity to ameliorate transition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultation services utilised proactive practices that took the initiative in relation to the receiving wards.
Originality/value
A lack of policy and divergent views on how to conceptualise palliative care appeared to be associated with variations in consultation practices, tentative approaches and a bottom-up driven development. This study adds knowledge, implying theoretical transferability as to how palliative care consultations can be practised, which is useful when designing and starting new consultation services.
Keywords
Acknowledgements
The authors would like to thank participating colleagues for sharing their knowledge and experiences about palliative consultations. Ethics approval and consent to participate: The project received ethical approval from the Swedish Ethical Review Authority, No. 809–16. Informed consent preceded participation for all of the participants. Consent for publication: Not applicable. Availability of data and material: The datasets generated and analysed during the current study are not publicly available due to the inclusion of potentially sensitive individual data about health status. The ethical approval includes a statement that the data will be kept in a private repository but are availablefrom the corresponding author on reasonable request. Funding: Sahlgrenska Academy at the University of Gothenburg. Authors’ contributions: JÖ, HB and JB planned the study. All authors conducted focus group interviews. Analysis and interpretation of focus group data was performed by SB with support from JÖ, HB and JB. SB wrote the first draft of the manuscript, JÖ, HB and JB commented on the manuscript and contributed to the final version. The final manuscript was read and approved by all authors. Competing interests: The authors declare that they have no competing interests.
Citation
Böling, S., Berlin, J.M., Berglund, H. and Öhlén, J. (2020), "No ordinary consultation – a qualitative inquiry of hospital palliative care consultation services", Journal of Health Organization and Management, Vol. 34 No. 6, pp. 621-638. https://doi.org/10.1108/JHOM-04-2020-0130
Publisher
:Emerald Publishing Limited
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