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Acute palliative care models: scoping review
  1. Shulamit Ohana,
  2. Adir Shaulov and
  3. Freda DeKeyser Ganz
  1. Nursing, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
  1. Correspondence to Ms Shulamit Ohana, nursing, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel; ohanashula{at}gmail.com

Abstract

Objective The goal of this scoping review is to identify the most commonly used models of palliative care delivery in acute care settings, their advantages and disadvantages, and to review existent research evidence in support of each model.

Methods We conducted an extensive search using EMBASE, Medline, CINAHL and Pubmed, using various combinations of terms relating to models in palliative care and acute care settings. Data were analysed using tabular summaries and content analysis.

Results 41 articles were analysed. Four models were identified: primary, consultative, integrative and hybrid models of palliative care. All four models have varying characteristics in terms of access to specialist palliative care; fragmentation of healthcare services; therapeutic relationships between patients and providers; optimal usage of scarce palliative care resources; timing of provision of palliative care; communication and collaboration between providers and clarity of provider roles. Moreover, all four models have different patient outcomes and healthcare utilisation. Gaps in research limit the ability to determine what model of care is more applicable in an acute care setting.

Conclusion No ideal model of care was identified. Each model had its advantages and disadvantages. Future work is needed to investigate which setting one model may be better than the other.

  • Hospital care
  • Quality of life
  • Symptoms and symptom management
  • Terminal care

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Footnotes

  • X @Shula

  • Contributors SO: planning, data collection, data analysis, writing of manuscript. FDG: planning, editing of manuscript. AS: data analysis, editing of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.