Primary Palliative Care for Emergency Medicine (PRIM-ER): Applying form and function to a theory-based complex...

Area of Science:

• Emergency Medicine
• Palliative Care
• Health Intervention Design

Background:

• Increasing acute exacerbations of chronic disease in older adults presenting to emergency departments.
• Palliative care delivery in emergency departments can enhance goal-concordant end-of-life care for this population.
• Need for large, pragmatic, complex health interventions in emergency medicine due to dynamic environments.

Purpose of the Study:

• To outline the theory-based design of the Primary Palliative Care for Emergency Medicine (PRIM-ER) intervention.
• To exemplify how PRIM-ER balances intervention fidelity with adaptability.
• To demonstrate a framework for developing complex health interventions in emergency settings.

Main Methods:

• Development of the Primary Palliative Care for Emergency Medicine (PRIM-ER) intervention.
• Utilizing a form and function matrix to define intervention objectives and components.
• Linking intervention components to the Theory of Planned Behavior to support provider behavior change.

Main Results:

• A form and function matrix identified key objectives and tailored components of PRIM-ER.
• Intervention components were mapped to the Theory of Planned Behavior.
• The design supports provider behavior change for palliative care delivery and referrals.

Conclusions:

• Theory application and form/function delineation are crucial for complex interventions.
• Prospective adaptation monitoring aids in balancing fidelity and adaptability.
• This approach supports successful implementation across diverse clinical environments.