Author: Fien Mertens
Prof. Dr. Peter Pype (Promotor Ghent University), Prof. Dr. Luc Deliens (Promotor, Vrije Universiteit Brussel)
Prof. Dr. Myriam Deveugele (Co-promotor, Ghent University)
The global need for palliative care increases due to population ageing and rises in incidence of cancer and other non-communicable diseases. Also medical developments have turned deadly diseases into more chronic conditions. Both demographic changes and evolutions in biomedical science have resulted in a growing complexity of the needs of patients with advanced progressive illness.
Healthcare professionals involved in palliative care delivery today are expected to be competent and keep pace with ongoing changes within healthcare, to collaborate inter-professionally, within and across palliative care settings and adapt to rapidly changing and uncertain conditions, in order to provide care that is tailored to the patient’s and family’s palliative care needs.
In Belgium, the first palliative care initiatives originated in 1980. In the light of the complexity of today’s palliative care, it is unclear how palliative care services currently collaborate to provide high-quality care. This thesis aimed to gain a deeper understanding in aspects of inter-professional collaboration in palliative care delivery.
In the first part of this thesis we investigated inter-professional collaboration in palliative home care and across palliative care settings. In the second part, we explored the experiences of patients and family carers with respect to transfers between care settings in palliative care as well as how these settings respond to patients’ needs. The third part investigated inter-professional collaboration in palliative home care form a complexity science perspective and workplace learning as
emergent behavior of inter-professional collaboration.
This dissertation has increased insights in inter-professional collaboration in palliative care delivery, through exploring the experiences of various professionals from diverse settings delivering palliative care, as well as family carers and patients with palliative care needs. Many positive experiences have been reported with respect to healthcare professionals’ commitment and dedication to provide high quality patient care. Results have nevertheless highlighted several aspects of inter-professional collaboration which can be improved, e.g. inter-professional communication and information exchange, agreeing on shared care goals, timely organizing of palliative home care – tailored to patient’s needs. Furthermore, viewing healthcare teams as complex adaptive systems offered explanations of multiple aspects of team behavior, e.g. the meaning of the attractors ‘quality of patient care delivery’, ‘inter-professional relationships’ and ‘personal and professional wellbeing’, workplace learning as emergent behavior. Finally, we found that WPL through collaboration can be considered an essential part of the continuing professional development.