International Observatory on End of Life Care, Lancaster University, Lancaster, UK.
Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
Palliat Med. 2021 May;35(5):814-829. doi: 10.1177/02692163211000660. Epub 2021 Mar 23.
Specialist palliative care services have a key role in a whole system response to COVID-19, a disease caused by the SARS-CoV-2 virus. There is a need to understand service response to share good practice and prepare for future care.
To map and understand specialist palliative care services innovations and practice changes in response to COVID-19.
Online survey of specialist palliative care providers (CovPall), disseminated via key stakeholders. Data collected on service characteristics, innovations and changes in response to COVID-19. Statistical analysis included frequencies, proportions and means, and free-text comments were analysed using a qualitative framework approach.
SETTING/PARTICIPANTS: Inpatient palliative care units, home nursing services, hospital and home palliative care teams from any country.
Four hundred and fifty-eight respondents: 277 UK, 85 Europe (except UK), 95 World (except UK and Europe), 1 missing country. 54.8% provided care across 2+ settings; 47.4% hospital palliative care teams, 57% in-patient palliative care units and 57% home palliative care teams. The crisis context meant services implemented rapid changes. Changes involved streamlining, extending and increasing outreach of services, using technology to facilitate communication, and implementing staff wellbeing innovations. Barriers included; fear and anxiety, duplication of effort, information overload and funding. Enablers included; collaborative teamwork, staff flexibility, a pre-existing IT infrastructure and strong leadership.
Specialist palliative care services have been flexible, highly adaptive and have adopted low-cost solutions, also called 'frugal innovations', in response to COVID-19. In addition to financial support, greater collaboration is essential to minimise duplication of effort and optimise resource use. https://doi.org/10.1186/ISRCTN16561225.
在应对由 SARS-CoV-2 病毒引起的 COVID-19 疾病方面，专科姑息治疗服务在整个系统中发挥着关键作用。有必要了解服务应对措施，以分享良好实践并为未来的护理做好准备。
绘制并了解专科姑息治疗服务在应对 COVID-19 时的创新和实践变化。
对专科姑息治疗提供者（CovPall）进行在线调查，通过主要利益相关者进行传播。收集有关服务特征、针对 COVID-19 的创新和变化的数据。统计分析包括频率、比例和平均值，使用定性框架方法分析自由文本评论。
设置/参与者：来自任何国家的住院姑息治疗单位、家庭护理服务、医院和家庭姑息治疗团队。
共收到 458 份回复：277 份来自英国，85 份来自欧洲（不包括英国），95 份来自世界（不包括英国和欧洲），1 份来自未知国家。54.8%的人在 2 个以上环境中提供护理；47.4%的医院姑息治疗团队，57%的住院姑息治疗单位和 57%的家庭姑息治疗团队。危机背景意味着服务迅速实施变革。这些变化涉及简化、扩展和增加服务的覆盖面，使用技术促进沟通，并实施员工福利创新。障碍包括恐惧和焦虑、工作重复、信息过载和资金不足。促成因素包括协作团队合作、员工灵活性、预先存在的 IT 基础设施和强大的领导力。
专科姑息治疗服务具有灵活性、高度适应性，并针对 COVID-19 采用了低成本解决方案，也称为“节俭创新”。除了财政支持外，还需要加强协作，以尽量减少工作重复并优化资源利用。https://doi.org/10.1186/ISRCTN16561225。
