Clinical trial NCT06140004: Home-Based Palliative Care Impact on Providers
Official title: Investigating the Impact of Person-Centered Home-Based Palliative Care on Providers
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Palliative Care
Health Personnel
Keywords: Home-based palliative care
Healthcare providers
Qualitative methods
Lead sponsor: University of Southern California
Sponsor class: OTHER
Collaborators: name: National Institute on Aging (NIA)
First posted: 2023-11-18
Enrollment: 24
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Participant were members of the HBPC service at each organization. The investigators sought participants with a wide variety of disciplines, roles, and experiences. This included targeting frontline providers consistent with the core clinical team outlined in the HBPC model (i.e., physician, nurse \[RNs\], social worker \[LCSWs, MSWs\], and chaplain), in addition to other site team members such as advance practice providers (NPs, PAs), patient coordinators/liaisons, admissions assistants, and leadership.

Brief summary: This research challenges our current approach to fee-for-service palliative care and is significant because it will advance the fields of palliative and person-centered care, clinical practice, public policy, and health care financing. However, the most important effect will be on seriously ill patients and their families through increased access to palliative care outside of hospitals, enhanced palliative continuity across health settings, and improved affordability via reformed payment structures. Nation-wide replication of reimbursable HBCP models is anticipated.

Detailed description: This study will undertake an effort to address the two-pronged gap in providing palliative care in the U.S. (episodic care and misaligned financing structures). This will be done by implementing an evidence-based Home-Based Palliative Care (HBPC) model-originally developed in managed care-into primary fee-for-service as a covered health benefit; the very first translation of this model by a private health insurer in the U.S. The purpose of the present study is to investigate the provider and organizational-level impact of implementing reimbursable HBPC in primary care with the goal of characterizing a set of implementation strategies and eliciting key mechanisms on how to widely replicate person-centered, reimbursable HBPC in primary care settings across the country. To this end, seven research questions will be answered that address the study purpose pertaining to feasibility, barriers, facilitators, person-centeredness, and job satisfaction. This study is guided by the Diffusion of Innovations theory. The investigators will conduct primary collection and analysis of qualitative focus group data at each study site. Key outcomes for the qualitative component include feasibility, barriers, and facilitators of translating HBPC, as well as characteristics associated with rate of HBPC diffusion and implementation strategies. This project challenges our current approach to fee-for-service palliative care and seeks to shift current research. Nation-wide replication of reimbursable HBCP models is anticipated.

Eligibility criteria: Inclusion Criteria:

• Current member of the Home-Based Palliative Care (HBPC) team or organization's leadership team

Exclusion Criteria:

* No interaction with palliative care patients or palliative care arm of organization
* Unable to speak and read English

Primary outcomes:
measure: Confidence in Team
timeFrame: 12-months
Secondary outcomes:
measure: Confidence in Self
timeFrame: 12-months
Other outcomes:
Locations:
city: Larkspur
country: United States
facility: By the Bay Health
state: California
city: Sacramento
country: United States
facility: Snowline Hospice
state: California
city: Signal Hill
country: United States
facility: HavenHealth
state: California
Study officials:
affiliation: University of Southern California
name: Alexis Coulourides Kogan, PhD
role: PRINCIPAL_INVESTIGATOR
References: