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Article
Publication date: 18 September 2020

Varsha Agarwal and Ganesh L.

The purpose of this paper is to investigate key milestones in development of standards of human rights to health care in particular context of addressing palliative care

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Abstract

Purpose

The purpose of this paper is to investigate key milestones in development of standards of human rights to health care in particular context of addressing palliative care, relevant efforts of advocacy in past decade and future area of growth.

Design/methodology/approach

In this study, analysis of human rights and its standards in context of palliative care has been provided through the lens of freedom from ill treatment and torture, right to health care and older persons’ and children’s rights.

Findings

Findings of this study highlighted significant developments in this area which include following: first treaty of human rights which explained right to palliative care; first resolution on palliative care by World Health Assembly; special rapporteur’s report focussed on denial of pain; and addressing issue of controlled medicine availability in special session of UN General Assembly.

Originality/value

Human rights standards and their development in context of palliative care have been most significant in relation to freedom from ill treatment and torture, right to health care and older persons’ rights. Further work is required in context of children’s rights and treaty bodies of human rights need to consistently address state obligations towards palliative care.

Details

International Journal of Human Rights in Healthcare, vol. 13 no. 4
Type: Research Article
ISSN: 2056-4902

Keywords

Content available

Abstract

Details

Leadership in Health Services, vol. 21 no. 4
Type: Research Article
ISSN: 1751-1879

Article
Publication date: 3 August 2020

Susanna Böling, Johan M. Berlin, Helene Berglund and Joakim Öhlén

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…

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.

Details

Journal of Health Organization and Management, vol. 34 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 30 June 2020

Siobhan Fox, Niamh O'Connor, Johnathan Drennan, Suzanne Guerin, W. George Kernohan, Aileen Murphy and Suzanne Timmons

The Model for Dementia Palliative Care Project will develop a service-delivery model for community-based dementia palliative care. Many countries provide dementia…

Abstract

Purpose

The Model for Dementia Palliative Care Project will develop a service-delivery model for community-based dementia palliative care. Many countries provide dementia palliative care services, albeit with considerable variability within these. However, little is known about what service providers consider to be the most important components of a dementia palliative care model. This study aimed to address this knowledge gap.

Design/methodology/approach

An exploratory design using a survey method was used as an initial phase of the wider project. A web-based survey was developed, piloted (n = 5), revised, and distributed within five healthcare jurisdictions: the Republic of Ireland, Northern Ireland, England, Scotland, and Wales. The target population was health and social care professionals, policymakers, and academics interested in dementia and palliative care. Content analysis of open-ended questions identified common themes; descriptive statistics were applied to the closed-ended questions.

Findings

Overall, N = 112 complete surveys were received. Key care principles incorporated the philosophies of palliative care and dementia care; many described “holistic” and “person-centred care” as the core. Important individual service components were the support for carers, advanced care planning, information, education and training, activities for “meaningful living”, comprehensive disease management, coordinated case management, and linking with community health services and social activities. Barriers included poor availability and organisation of healthcare services, stigma, misconceptions around dementia prognosis, insufficiently advanced care planning, and dementia-related challenges to care. Facilitators included education, carer support, and therapeutic relationships.

Originality/value

This study, as part of the larger project, will directly inform the development of a novel service delivery Model of Dementia Palliative Care for Ireland. The results can also inform service planning and design in other countries.

Details

Journal of Integrated Care, vol. 28 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 June 2005

Graydon Davison

To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an…

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Abstract

Purpose

To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an uncertain, complex and dynamic environment.

Design/methodology/approach

A range of literature was reviewed to suggest configuration and characteristics that were tested using semi‐structured interviews with the senior medical staff member at each of three Australian case study organisations. Data gathered from these interviews was supplemented with data gathered from semi‐structured interviews with multidisciplinary management teams and patient care teams dealing with inpatients and home‐care patients.

Findings

A hybrid configuration is suggested, based on Mintzberg's typology of organisations. Responses from interviews modify some characteristics of the suggested configuration, though generally appearing to support it. Characteristics of the external and internal environments are described.

Research limitations/implications

Palliative care is rarely written off outside the healthcare literature and comparatively infrequently within it. Configuration is used to suggest the characteristics of innovative teams in an uncertain, dynamic, complex environment. The use and management of multidisciplinary patient care teams in palliative care offers interesting insights for a broad range of organisations.

Practical implications

A contribution to the discourse on the relationship between configuration and innovation based in organisations without commercial imperative, delivering multi‐level care for and by people involved in the end‐of‐life process.

Originality/value

The paper continues a line of publications, beginning in 2002, describing the management of innovation in multidisciplinary palliative care teams. The originality and value of this paper and this line of research is in taking a management view of a unique environment that offers insights and lessons to a broad range of organisations.

Details

European Journal of Innovation Management, vol. 8 no. 2
Type: Research Article
ISSN: 1460-1060

Keywords

Article
Publication date: 14 February 2019

Marina Raco, Teresa Burdett and Vanessa Heaslip

Due to an international ageing population, global health organisations have recognised the challenges arising from fragmented interaction between health and social sectors…

Abstract

Purpose

Due to an international ageing population, global health organisations have recognised the challenges arising from fragmented interaction between health and social sectors in the end of life care. The purpose of this paper is to explore the existing literature on integrative palliative care services for older people.

Design/methodology/approach

An integrative review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Papers included in the review focused upon integrated care within palliative care systems (January 2007–2017). A certain number of papers were excluded when the review focused on individuals younger than 65, not written in English and not being focused on integrated palliative care.

Findings

Nine studies fitted the inclusion criteria and three themes were identified: person-centred care, co-ordination of care, and education and training. The review identifies that integrated palliative care requires co-ordinated techniques that focus upon the quality of life, individual needs and awareness of vulnerability rather than fixation on inevitable mortality.

Research limitations/implications

The emerging presence of the need for integrated palliative care requires further research in order to develop coherent models of integrated palliative care which can be incorporated into practice.

Originality/value

This review identified themes relevant to the emerging issues in the global health sector of end of life care. The literature suggests that the optimised use of an integrated care approach to a palliative model of care is required and in need of further investigation.

Details

Journal of Integrated Care, vol. 27 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

Case study
Publication date: 3 June 2017

Sangeeta Shukla and Saloni Sinha

The subject areas are business communication, human resource management and health care.

Abstract

Subject area

The subject areas are business communication, human resource management and health care.

Study level/applicability

The case was designed for use in a first-year MBA-level course in business communication but would serve well in a course for executives or for advanced undergraduates. It might also be assigned in general management courses to evoke discussion on communication skills required in sensitive and critical situations; human resource courses; and course on health care.

Case overview

Palliative care is a specialized medical care focussing on improving the quality of life of patients suffering from life-threatening illnesses. It addresses symptom management and psychosocial and spiritual concerns of the patient and its caregivers. With the intent to alleviate the sufferings of terminally ill patients, Rajbala Foundation, a non-government organization (NGO), works at the psychosocial and spiritual levels. While training their volunteers in effective palliative care communication, it often encounters challenges such as socio-cultural variations, organizational challenges, appropriate verbal and nonverbal communication, etc. This teaching case focuses on the communication challenges faced by the volunteers of Rajbala Foundation. It would lead to a broader discussion on communicating empathically during critical situations. The case has a focus on NGOs, and non-profit organizations, public sector management, health-care management and human resources management. There is significant literature on communication skills for medical practitioners in palliative care. As an increasing number of NGOs step in to provide the second level of care to critically ill patients in non-physical domains, there is a need to understand the role of effective communication for such care providers. This case deals with non-medical care providers in palliative care; the issues of communication they face as they interact with patients; and the skills they require to address the emotional and spiritual needs of patients and their families.

Expected learning outcomes

The aim of this case is to raise awareness of the complexities involved in the communication process during an emotional and sensitive interaction. It aims to encourage volunteers involved in palliative care to reflect on good communication practices when communicating with patients and family members. After reading this case, the students should be able to discuss the complexities involved in the communication process when communicating in situations with high emotional involvement; understand the core elements of emotional interactions for effective practice; and emphasize the need for the development of communication skills within palliative care.

Supplementary materials

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 6: Human Resource Management

Details

Emerald Emerging Markets Case Studies, vol. 7 no. 2
Type: Case Study
ISSN: 2045-0621

Keywords

Article
Publication date: 1 June 2002

Graydon Davison and Paul Hyland

This paper is the first in a series that will examine the management of innovation by cross‐functional, multi‐disciplinary patient care teams in a palliative care

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Abstract

This paper is the first in a series that will examine the management of innovation by cross‐functional, multi‐disciplinary patient care teams in a palliative care environment. This highly innovative environment is singularly focused on relieving the suffering of patients and their socially related carers during an end of life experience. The singular focus enables and encourages palliative care practitioners to break through and diminish or accommodate professionally‐based paradigm conflicts and organisational politics. This facilitates collaborative team‐based efforts, including the patient and the patient’s social support group, to address the multi‐causal uncertainties that characterise end of life in palliative care. The continuous innovation model used in the European Union funded CIMA project is used as a starting point for this research. While many businesses have struggled to implement self‐regulating teams and have invested considerable resources in attempting to gain some advantage from teamwork it appears palliative care professionals have adopted self‐regulating work teams in a highly uncertain environment as the most suitable human resource structure and practice.

Details

Team Performance Management: An International Journal, vol. 8 no. 3/4
Type: Research Article
ISSN: 1352-7592

Keywords

Article
Publication date: 1 June 2008

Irene Tuffrey‐Wijne, Leopold Curfs and Sheila Hollins

This paper explores access to palliative care services by people with learning disabilities. It is based on a study of specialist palliative care professionals in London…

217

Abstract

This paper explores access to palliative care services by people with learning disabilities. It is based on a study of specialist palliative care professionals in London, involving 32 semi‐structured interviews and 543 postal questionnaires. We focus on one aspect of the findings, related to the current use of specialist palliative care services by people with learning disabilities. The results indicate that such services are under‐used by this group. We discuss possible reasons for low referral rates, including late diagnosis and lack of understanding among both learning disability services and palliative care services about each other's roles. We highlight the importance of collaboration, and the need for further staff training.

Details

Advances in Mental Health and Learning Disabilities, vol. 2 no. 2
Type: Research Article
ISSN: 1753-0180

Keywords

Article
Publication date: 11 June 2018

Henry O’Lawrence and Rohan Chowlkar

The purpose of this paper is to determine the cost effectiveness of palliative care on patients in a home health and hospice setting. Secondary data set was utilized to…

Abstract

Purpose

The purpose of this paper is to determine the cost effectiveness of palliative care on patients in a home health and hospice setting. Secondary data set was utilized to test the hypotheses of this study. Home health care and hospice care services have the potential to avert hospital admissions in patients requiring palliative care, which significantly affects medicare spending. With the aging population, it has become evident that demand of palliative care will increase four-fold. It was determined that current spending on end-of-life care is radically emptying medicare funds and fiscally weakening numerous families who have patients under palliative care during life-threatening illnesses. The study found that a majority of people registering for palliative and hospice care settings are above the age group of 55 years old.

Design/methodology/approach

Different variables like length of stay, mode of payment and disease diagnosis were used to filter the available data set. Secondary data were utilized to test the hypothesis of this study. There are very few studies on hospice and palliative care services and no study focuses on the cost associated with this care. Since a very large number of the USA, population is turning 65 and over, it is very important to analyze the cost of care for palliative and hospice care. For the purpose of this analysis, data were utilized from the National Home and Hospice Care Survey (NHHCS), which has been conducted periodically by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Descriptive statistics, χ2 tests and t-tests were used to test for statistical significance at the p<0.05 level.

Findings

The Statistical Package for Social Sciences (SPSS) was utilized for this result. H1 predicted that patients in the age group of 65 years and up have the highest utilization of home and hospice care. This study examined various demographic variables in hospice and home health care which may help to evaluate the cost of care and the modes of payments. This section of the result presents the descriptive analysis of dependent, independent and covariate variables that provide the overall national estimates on differences in use of home and hospice care in various age groups and sex.

Research limitations/implications

The data set used was from the 2007 NHHCS survey, no data have been collected thereafter, and therefore, gap in data analysis may give inaccurate findings. To compensate for this gap in the data set, recent studies were reviewed which analyzed cost in palliative care in the USA. There has been a lack of evidence to prove the cost savings and improved quality of life in palliative/hospice care. There is a need for new research on the various cost factors affecting palliative care services as well as considering the quality of life. Although, it is evident that palliative care treatment is less expensive as compared to the regular care, since it eliminates the direct hospitalization cost, but there is inadequate research to prove that it improves the quality of life. A detailed research is required considering the additional cost incurred in palliative/hospice care services and a cost-benefit analysis of the same.

Practical implications

While various studies reporting information applicable to the expenses and effect of family caregiving toward the end-of-life were distinguished, none of the previous research discussed this issue as their central focus. Most studies addressed more extensive financial effect of palliative and end-of-life care, including expenses borne by the patients themselves, the medicinal services framework and safety net providers or beneficent/willful suppliers. This shows a significant hole in the current writing.

Social implications

With the aging population, it has become evident that demand of palliative/hospice care will increase four-fold. The NHHCS have stopped keeping track of the palliative care requirements after 2007, which has a negative impact on the growing needs. Cost analysis can only be performed by analyzing existing data. This review has recognized a huge niche in the evidence base with respect to the cost cares of giving care and supporting a relative inside a palliative/hospice care setting.

Originality/value

The study exhibited that cost diminishments in aggressive medications can take care of the expenses of palliative/hospice care services. The issue of evaluating result in such a physically measurable way is complicated by the impalpable nature of large portions of the individual components of outcome. Although physical and mental well-being can be evaluated to a certain degree, it is significantly more difficult to gauge in a quantifiable way, the social and profound measurements of care that help fundamentally to general quality of care.

Details

International Journal of Organization Theory & Behavior, vol. 21 no. 2
Type: Research Article
ISSN: 1093-4537

Keywords

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