Using Palliative Care Needs Rounds in the UK for care home staff and residents: an implementation science study

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Care home residents often have limited access to specialist palliative care.
• Palliative Care Needs Rounds offer a novel solution to this gap.
• The study aimed to adapt and implement this model in the UK.

Purpose of the Study:

• To co-design and implement a scalable UK model of Palliative Care Needs Rounds.
• To understand the factors influencing the successful implementation of Needs Rounds.
• To evaluate the impact of Needs Rounds on resident care and staff capabilities.

Main Methods:

• A pragmatic implementation study using the Promoting Action on Research Implementation in Health Services (PARIHS) framework.
• Conducted across six UK sites with specialist palliative care services and multiple care homes.
• Utilized mixed methods including interviews, workshops, questionnaires, and fidelity assessments.

Main Results:

• Needs Rounds facilitate collaboration between care home and specialist palliative care staff, enhancing resident care planning.
• The intervention builds staff confidence, strengthens relationships, and improves understanding of end-of-life care needs.
• Despite challenges like COVID-19, the study identified a programme theory for successful implementation.

Conclusions:

• Palliative Care Needs Rounds can improve the quality of life and death for care home residents.
• The approach enhances staff skills, confidence, and communication regarding symptom management and care planning.
• Strengthening relationships between care home and specialist palliative care staff is a key benefit.