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Background

Palliative care is a critical aspect of healthcare, aiming at easing symptoms and agony for people with incurable medical illnesses experience. Palliative care is challenging and misunderstood; patients must be made aware and prepared for it. Despite the expansion of palliative care programs and needs over the past few decades, there may still be knowledge gaps and misconceptions among patients and providers about palliative care patients (and caregivers) who were eligible for palliative care have little knowledge of it (Cardenas et al., 2021). Research shows many people with life-limiting illnesses do not receive palliative treatment (McCarthy, 2021). This reluctance is due to misconceptions, fear of the unknown, and a belief that palliative care means "giving up" curative treatments (Hui et al., 2019). This project uses educational intervention to increase patient readiness for palliative care and ensure timely assistance. Patients arriving at Briarwood Palliative Care Clinic are unprepared for their first appointments. Providers spend most of the initial consultation explaining and educating patients about palliative care.

There are educational tools currently in place that patients receive prior to their initial consultation. However, according to the providers the materials are not being read, or being understood and they are not effective in educating their patients and families. Even after the primer document has been sent much of the provider’s time is spent addressing issues that were explained and outlined in the document.

Purpose & Objectives

The project aims to improve patient readiness for palliative care before the initial appointment. The objectives are to 1. Using provider feedback to evaluate patient readiness during the new patient’s initial visit prior to the educational intervention and 2. By utilizing provider assessment to develop educational resources to improve patient readiness for the initial consultation with palliative care providers. 3.Evaluate and measure the effectiveness of the intervention using provider analysis for potential modifications and improvements for future patient readiness.

Implementation Plan

The educational intervention will be at Briarwood Palliative Care clinic over an 8-week timeframe.  PI is a DNP student and not an employee at the Briarwood Palliative Care clinic in Ann Arbor. Dr. April Bigelow, as the co-investigator, is a nurse practitioner at the clinic. The patient population: new patients aged 18 or older, of any race, ethnicity or gender, with serious or life-limiting conditions. The pre-intervention survey will be given to providers to establish the current level of patient knowledge regarding palliative care. Options for educational posters will be placed in patient rooms selected by the PI. Options will be presented to the providers regarding which posters they will place in selected patient rooms. The post-intervention survey will be given to the providers to determine the effectiveness of the posters after eight weeks. Pre-post- anonymous survey utilizing Qualtrics through email. Providers were allowed to participate in the survey after being informed of its goal. Providers were informed that survey responses would remain anonymous, and no patient-identifying information was collected. Both surveys were designed using a 5-point Likert Scale for the convenience of the participants. During this project, both quantitative and qualitative data will be collected. Descriptive statistics will be used to analyze the quantitative data, and the closed-ended questions will be thematically analyzed for the providers after both sets of surveys have been completed.

Short-term outcome will better informed patients and more productive use of provider consultation time. The long-term outcome may include revision of existing educational material improving productivity further. This may consist of modifying or making improvements to the educational materials and including educational posters (and copyright privileges have been obtained for poster use in the patient rooms) planned throughout the palliative department. The sample size limits generalizability. The sample is limited to the new patients only attending Briarwood Palliative Care Clinic in Ann Arbor during the 8-week timeframe. This project is a pilot program, being used to test effectiveness in a single setting. This project readily applicable as devised in other clinical settings.