ArticleBMC palliative care2025
Understanding the acute care context to inform palliative care improvements: a qualitative study of hospital-based multidisciplinary clinicians.
Article in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A cost analysis of implementing facilitated improvements in hospital palliative care using patient reported experience measures: the LEAHP (Listen Empower Act - Hospital Palliative care) bundle.BMC palliative care · 2026Article
- Experiences of End-of-Life Care Among Medical Staff in Acute Care Hospitals: A Qualitative Study.Journal of hospice and palliative care · 2026Article
- Improving patient reported experience in inpatients with palliative care needs: a pre-post quality improvement study.BMC palliative care · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPopulation ageing and rising levels of non-communicable diseases are increasing the number of people living with and dying from advanced serious illnesses globally. Many of these people are hospitalised more than once in their last year of life. While there is sound evidence on what patients and their families require for safe and high-quality hospital palliative care, enabling this remains a challenge. This study aimed to understand the clinician, team, and organisational-level barriers and enablers to integrating good palliative care into acute care.
methodsAn exploratory-descriptive, qualitative study involving semi-structured interviews and practical thematic analysis was conducted. Medical, nursing and allied health disciplines were recruited from three wards (cancer care, mixed general medicine/renal and mixed general medicine/respiratory) within a large Australian metropolitan hospital.
resultsEighty-eight interviews (nursing (n = 39); medicine (n = 24); allied health (n = 25)) were undertaken, with a median duration of 25.5 min (range 5 to 55 min). Most participants were female (n = 73, 83%), holding a Bachelor's degree (n = 86, 98%) and ranged from new graduates to participants with over 40 years of post-registration experience. The analysis generated six themes, reflecting the challenges of providing optimal palliative care within acute hospital wards: 1. Understanding when and how to provide palliative care 2. Negotiating shared or changing medical governance in a siloed system 3. Supporting clinicians with the knowledge, skills and confidence to meet palliative care needs 4. Prioritising palliative care amidst the acute care demands of the hospital 5. Optimising the clinical environment to enable private, restful and family-friendly spaces 6. Harnessing organisational support and multidisciplinary clinical leadership
conclusionsThis study reveals complex, multi-level organisational barriers to integrating palliative care within the acute hospital which will need to be addressed for effective and sustained improvement. Harnessing organisational support and multidisciplinary clinical leadership is key to successful change. Improvements with a focus on developing clinician knowledge, skills, and confidence in palliative care need to pay attention to organisational siloes that constrain shared care, cultures of care that prioritise cure and efficiency, clinical uncertainty in the context of advanced serious illness and optimising the environment for quality palliative care.
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