A community-academic partnership to improve palliative care in post-acute and long-term care settings

Palliative care in post-acute and long-term care (PALTC) settings is often inadequate due to limited access to trained clinicians, leaving seriously ill residents with unmet needs. We established a partnership between a national PALTC organization and an academic school of nursing to build the infrastructure for improving palliative care capacity. This paper describes the formation of a partnership and the initial efforts to lay the groundwork to improve palliative care delivery in PALTC settings. Guided by community-engaged research principles and an adapted comparative effectiveness research framework, we convened a community advisory board to co-develop the project. Using a brief survey, we identified staff-reported gaps in palliative care across nine PALTC settings in two states. A total of 163 staff completed the survey, and the majority expressed positive attitudes toward palliative care. However, shortcomings were identified in knowledge of advanced dementia and symptom management. Staff cited limited staffing, inadequate training, and communication as major barriers to palliative care delivery. Priority areas for improvement include palliative care skill-building, strengthening team-based and family-centered communication, and developing organizational strategies that support consistent comfort-oriented care. This partnership established preparatory infrastructure essential for implementing and testing a quality improvement palliative care program in PALTC.