Hub and Spokes-Implementation of Basic Palliative Care into University Hospital Practice-A Pilot Study

Area of Science:

• Palliative Care
• Healthcare Management
• Medical Education

Background:

• Limited knowledge of basic palliative care can impact patient outcomes.
• Effective implementation strategies are needed to integrate palliative care principles into diverse clinical settings.
• The Hub and Spokes model offers a structured approach for disseminating specialized knowledge.

Purpose of the Study:

• To implement basic palliative care knowledge in selected hospital departments using the Hub and Spokes model.
• To assess the acceptability, feasibility, and adoption of this training model.
• To evaluate the differences in implementation outcomes between medical and nursing professions.

Main Methods:

• A 2-year stepwise training program involving skills lectures for designated expert representatives (one physician, two nurses per department).
• Six oncological and non-oncological departments participated.
• Semi-structured interviews with 12 nurses and 6 physicians were conducted to evaluate outcomes.

Main Results:

• High overall acceptability and feasibility were reported across all departments and professions.
• Adoption and penetration of trained representatives varied between physicians and nurses.
• Implementation was more successful in inpatient (stationary) settings, with low associated costs.

Conclusions:

• The Hub and Spokes model is an acceptable and feasible method for implementing basic palliative care knowledge.
• Targeted training of expert representatives can facilitate palliative care integration.
• Further expansion and follow-up are planned to ensure the sustainability of this initiative.