Department of Occupational Therapy, Medstar Georgetown University Hospital, Washington, D.C. USA.
MGH Institute of Health Professions, Boston, MA.
Am J Hosp Palliat Care. 2024 Jun;41(6):601-609. doi: 10.1177/10499091231184621. Epub 2023 Jul 18.
Palliative care and rehabilitation professionals caring for seriously ill people and their families face barriers to effective, timely collaboration. Barriers such as ineffective communication processes, role misunderstanding across professions, and resource limitations can lead to underutilization of rehabilitation services for this vulnerable population. To create practical connections between palliative care and rehabilitation professionals and to provide tools and strategies for teams to develop the core competencies (role clarity, communication, teamwork, and shared values) necessary to provide coordinated, timely, effective care to people living with serious illness. With Interprofessional Education Collaborative (IPEC) Core Competencies1 as a framework for interprofessional collaborative practice, a quality improvement project was conducted at a large academic medical center. The 5-phase project included literature review, expert interviews, identification of barriers and facilitators, development of strategies to mitigate barriers, and pilot testing of select strategies. The PalRehab Toolkit consists of strategies to enhance interprofessional collaborative practice and infuse rehabilitation into palliative care in the acute care setting. Preliminary evaluation of piloted strategies suggests increased communication across professions, improved role clarity, and an increased likelihood of collaboration. Providing educational offerings, establishing efficient communication channels, and infusing rehabilitation concepts into palliative care practices, as outlined in the PalRehab Toolkit, may positively impact interprofessional collaborative practice and improve care delivery for people with serious illness and their families.
姑息治疗和康复专业人员在照顾重病患者及其家属时，面临着有效、及时合作的障碍。沟通流程效率低下、跨专业角色理解有误以及资源有限等障碍，可能导致这一弱势群体无法充分利用康复服务。为了在姑息治疗和康复专业人员之间建立实际联系，并为团队提供工具和策略，以发展提供协调、及时、有效的护理所需的核心能力（角色明确、沟通、团队合作和共同价值观），以服务于患有严重疾病的人群。该项目以医疗学术中心为基地，以跨专业教育合作联合会（IPEC）核心能力 1 为框架，开展了一项质量改进项目。该 5 阶段项目包括文献综述、专家访谈、识别障碍和促进因素、制定减轻障碍的策略以及对精选策略进行试点测试。PalRehab 工具包包含了增强跨专业合作实践并将康复融入急性照护环境中的姑息治疗的策略。对试点策略的初步评估表明，各专业之间的沟通有所增加，角色清晰度有所提高，合作的可能性也有所增加。提供教育课程、建立高效的沟通渠道，并将康复概念融入姑息治疗实践中，如 PalRehab 工具包中所述，可能会对跨专业合作实践产生积极影响，并改善对重病患者及其家属的护理服务。
