Background Person-centred, holistic care is one of the foundations of palliative care (NICE, 2011). Finding out patients’ stories and what’s important to them provides a starting point for doing this (Henry, 2015). However, conversations with health professionals often focus on problems/symptoms and as a result it can be difficult to stay focused on patients’ priorities and goals (Boa et al., 2014).
Aims We aimed to: Explore how staff in a hospice inpatient-unit get to know patients and families and find out what is important to them. Identify and implement a guided conversation tool to help professionals capture stories and priorities in a consistent way. Implement structures and processes to ensure information is communicated to and used by the whole team.
Methods Initial observations of admission interviews with patients and families were carried out and case notes analysed to see what staff documented in relation to patients’ stories and goals. A conversation guide was devised, based on a rehabilitative, functional information-gathering approach. Processes were put in place to share the information across the team. Observations and case notes analysis were repeated after implementation.
Results Initial observations showed that staff often had conversations with patients and families about what was important to them but this was rarely documented. A guided conversation tool and the supporting documentation and processes helped the whole team get to know patients and families better. As a result the emphasis of professional work shifted from clinically-orientated priorities to supporting patients/families to work towards goals that were important to them in the context of their individual story.
Conclusion Providing a conversation guide and supporting communication can help professionals capture patients’ stories more consistently. As a result, care is delivered and documented in a more person- centred way.
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