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Hub and Spokes-Implementation of Basic Palliative Care into University Hospital Practice-A Pilot Study
Caroline Hertler, Markus Feuz, Markus Schettle1
1Competence Center for Palliative Care, Department of Radiation Oncology, University Hospital and University of Zurich, Zurich, Switzerland.
Abstract:
The aim is to implement knowledge of basic palliative care in selected departments by the Hub and Spokes model. Implementation of basic palliative care was designed as a stepwise training model by skills lectures over a time period of 2 years. In each of the six selected oncological and nononcological departments, one physician and two nurses were trained in semi-annual half-day meetings as expert representatives within their departments. Semi-structured interviews were conducted to assess implementation outcomes with 12 nurses and 6 physicians. Overall acceptability was high for all departments and professions. Feasibility was given in all departments. Adoption and penetration of a trained expert representative differed between medical and nursing professions. Implementation was more appropriate in the stationary sector. Implementation costs were low. Expansion of the system into a second follow-up period, including more departments, is planned to ensure sustainability.
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