This Article Full Text (OnlineFirst PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Ingleton, C Articles by Seymour, J PubMed PubMed Citation Articles by Ingleton, C Articles by Seymour, J Social Bookmarking                         What's this?

Barriers to achieving care at home at the end of life: transferring patients between care settings using patient transport services

¹ Centre for Health and Social Care Studies, The University of Sheffield, Sheffield
² Division of Health Research, Lancaster University, Lancaster
³ School of Health Studies, University of Bradford, Bradford
⁴ School of Nursing, University of Nottingham, Nottingham

^* To whom correspondence should be addressed.

	Abstract

Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdom by the Marie Curie Cancer Care ‘Delivering Choice Programme'. This article explores perceptions of service users and key stakeholders of palliative care services about problems encountered in journeys between care settings during end-of-life care. This article draws on data from interviews with stakeholders (n = 44), patients (n = 16), carers (n = 19) and bereaved carers (n = 20); and focus groups (n = 9) with specialist nurses. Data were gathered in three areas of the United Kingdom. Data were analysed using a framework approach. Transport problems between care settings emerged as a key theme. Four particular problems were identified: (1) urgent need for transport due to patients' rapidly changing condition; (2) limited time to organise transfers; (3) the management of specialist equipment and (4) the need to clarify the resuscitation status of patients. Partnership working between Ambulance Services and secondary care is required to develop joint protocols of care to ensure timely and safe transportation between care settings of patients, who are near their end of life. Commissioning of services should be responsive to the complexities of patients' needs and those of their families.

Key Words: dying, end-of-life care, patient transport services, transfers between care settings

First published on July 30, 2009
Palliative Medicine 2009, doi:10.1177/0269216309106893


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?