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American Journal of Hospice and Palliative Medicine®
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1049909108319265v1
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Article

Provider Insights About Palliative Care Barriers and Facilitators: Results of a Rapid Ethnographic Assessment

Julius G. Goepp, MD1*, Simon Meykler, BA2, Nancy E. Mooney, RN2, Claudia Lyon, DO2, Rosanne Raso, RN2, and Kell Julliard, MA2

1 Lupine Creative Consulting, Inc
2 Lutheran Medical Center

* To whom correspondence should be addressed. E-mail: jg{at}lupinecreative.com.


  Abstract
Palliative care remains underutilized in the United States. This may represent failure of translation of research into practice (diffusion of innovation). Qualitative methods can identify barriers to and facilitators of diffusion of innovation. The aim is to identify potential barriers to and facilitators of inpatient palliative care utilization at a large urban hospital, as articulated by health professionals. Rapid ethnographic assessment methods were used among health professionals with subsequent extraction of predominant themes illuminating factors influencing adoption of palliative care services. In all, 3 stakeholder categories and 7 major themes emerged. Analysis revealed consistent need for organized, cross-disciplinary education/training services and a clearly-defined team approach. Denial at all stakeholder levels and in most themes was a barrier to implementation of palliative care. Consistent, defined educational, policymaking, and procedural standards were requirements for best adoption of palliative care. Denial was a striking obstruction to diffusion of innovation.

First published on June 11, 2008, doi:10.1177/1049909108319265

American Journal of Hospice and Palliative Medicine® 2008;25:309.

A more recent version of this article appeared on August 1, 2008

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