Evidence map›Paper›PMID 40676716›Full record

Trial reportPalliative & supportive care2025

Formative evaluation of an employee-driven approach to improve care in the dying phase in hospitals.

Sophie Meesters, Sukhvir Kaur, Viola Milke, Christin Herrmann, Aneta Schieferdecker, Nikolas Oubaid, Karin Oechsle, Holger Schulz, Holger Pfaff, Raymond Voltz and 1 more

Abstract readClinical Trial
In one paragraph

Trial report in Palliative & supportive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sophie MeestersPalliative Medicine, University Hospital Augsburg, Augsburg, Germany.
Sukhvir KaurDepartment of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.ORCID https://orcid.org/0009-0001-6252-6193
Viola MilkePalliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christin HerrmannChair of Quality Development and Evaluation in Rehabilitation, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences & Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Aneta SchieferdeckerPalliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Nikolas OubaidPalliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Karin OechslePalliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Holger SchulzDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Holger PfaffChair of Quality Development and Evaluation in Rehabilitation, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences & Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Raymond VoltzDepartment of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Kerstin KremeikeDepartment of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe hospital setting is often perceived as slow to change. While employee-driven approaches offer a promising alternative to traditional top-down methods, guidance is limited. This study provides a description and formative evaluation of an employee-driven working group (WG) approach to tailor ward-specific measures to improve care in the dying phase. The aim is to evaluate the WG process and offer practical insights for transferability to other hospitals.

methodsFormative mixed-methods evaluation of a WG process to tailor ward-specific evidence-informed measures on 10 wards outside specialized palliative care at 2 German medical centers. To analyze factors relevant for the WG process, the

resultsMultiprofessional WGs were established on all hospital wards, with an average of 7 meetings per ward within 1 year and 4 participants per meeting. Adapting the process to participants' wishes and needs were crucial, particularly regarding the desired degree of external input. We identified 4 barriers (e.g. declining participation, institutional limits) and 7 facilitators (e.g. involvement of staff in leading positions, multiprofessional composition). The WGs tailored 34 measures, e.g. team meetings to improve communication within the team. Participants' views were generally positive: 91% felt able to share their thoughts, 66% were satisfied with the outcome, and 77% would participate again. SIGNIFICANCE OF

resultsThe employee-driven approach was feasible and useful for tailoring ward-specific measures. However, integrating top-down elements proved to be beneficial. The identified barriers and facilitators provide insights for transferring an employee-driven approach to other hospitals to improve care in the dying phase outside specialized palliative care settings. CLINICAL

trial registrationThe study was registered in the German Clinical Trials Register (DRKS00025405).

Indexed as

Terminal CareFemaleFocus GroupsGermanyHospitalsHumansMalePalliative CareQualitative ResearchQuality ImprovementSurveys and Questionnaireshospitalsmixed-methodsparticipatory researchquality of health careTerminal care

Identifiers

PMID40676716
PMCPMC13166520

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.