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Electronic palliative care coordinating systems (EPaCCS) may not facilitate home deaths: a mixed methods evaluation of end of life care in two English counties

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Electronic palliative care coordinating systems (EPaCCS) may not facilitate home deaths : a mixed methods evaluation of end of life care in two English counties. / Wye, Lesley; Lasseter, Gemma; Simmonds, Bethany; Duncan, Lorna; Percival, John; Purdy, Sarah.

In: Journal of Research in Nursing, Vol. 21, No. 2, 03.2016, p. 96-107.

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Wye, Lesley ; Lasseter, Gemma ; Simmonds, Bethany ; Duncan, Lorna ; Percival, John ; Purdy, Sarah. / Electronic palliative care coordinating systems (EPaCCS) may not facilitate home deaths : a mixed methods evaluation of end of life care in two English counties. In: Journal of Research in Nursing. 2016 ; Vol. 21, No. 2. pp. 96-107.

Bibtex

@article{d73ceb03558d46cb9c71af7f34631b9f,
title = "Electronic palliative care coordinating systems (EPaCCS) may not facilitate home deaths: a mixed methods evaluation of end of life care in two English counties",
abstract = "Electronic palliative care coordination systems (EPaCCS) detail preferred place of death across health and voluntary sector boundaries. Quantitative studies suggest that individuals recorded on EPaCCS are more likely to die at home. This study aimed to explore this relationship between EPaCCS and home deaths. Patient records from EPaCCS were collected from 1 September 2011 to 29 February 2012, linked to death data and analysed using descriptive statistics. We interviewed 101 professionals, including community nurses, and employed framework analysis. Few eligible patients were entered on EPaCCS (9% North Somerset, 13% Somerset). Of those, the majority died in community settings (87%, 81/93 North Somerset; 93% 307/331 Somerset). However, interviews and EPaCCS record analysis suggested that EPaCCS was almost exclusively used by community nurses and GPs, so, unsurprisingly, the relationship between EPaCCS and home deaths was strong. Difficulties included professional reluctance to discuss death, and the burden of data entry falling on daytime staff for out-of-hours colleagues. These results challenge assumptions that EPaCCS facilitates increased home deaths, as qualitative investigation identified selection bias. To avoid misinterpretations, future studies should employ mixed methods. The implementation of an electronic tool is not enough on its own to ensure that advanced care wishes are available, as long-standing organisational and cultural issues, such as professionals working in silos and professional reluctance to have {\textquoteleft}end of life{\textquoteright} discussions, also need to be addressed.",
keywords = "end of life care, EPaCCS, home deaths, palliative care, preferred place of care, preferred place of death",
author = "Lesley Wye and Gemma Lasseter and Bethany Simmonds and Lorna Duncan and John Percival and Sarah Purdy",
year = "2016",
month = mar
doi = "10.1177/1744987116628922",
language = "English",
volume = "21",
pages = "96--107",
journal = "Journal of Research in Nursing",
issn = "1744-9871",
publisher = "SAGE Publications Inc.",
number = "2",

}

RIS

TY - JOUR

T1 - Electronic palliative care coordinating systems (EPaCCS) may not facilitate home deaths

T2 - a mixed methods evaluation of end of life care in two English counties

AU - Wye, Lesley

AU - Lasseter, Gemma

AU - Simmonds, Bethany

AU - Duncan, Lorna

AU - Percival, John

AU - Purdy, Sarah

PY - 2016/3

Y1 - 2016/3

N2 - Electronic palliative care coordination systems (EPaCCS) detail preferred place of death across health and voluntary sector boundaries. Quantitative studies suggest that individuals recorded on EPaCCS are more likely to die at home. This study aimed to explore this relationship between EPaCCS and home deaths. Patient records from EPaCCS were collected from 1 September 2011 to 29 February 2012, linked to death data and analysed using descriptive statistics. We interviewed 101 professionals, including community nurses, and employed framework analysis. Few eligible patients were entered on EPaCCS (9% North Somerset, 13% Somerset). Of those, the majority died in community settings (87%, 81/93 North Somerset; 93% 307/331 Somerset). However, interviews and EPaCCS record analysis suggested that EPaCCS was almost exclusively used by community nurses and GPs, so, unsurprisingly, the relationship between EPaCCS and home deaths was strong. Difficulties included professional reluctance to discuss death, and the burden of data entry falling on daytime staff for out-of-hours colleagues. These results challenge assumptions that EPaCCS facilitates increased home deaths, as qualitative investigation identified selection bias. To avoid misinterpretations, future studies should employ mixed methods. The implementation of an electronic tool is not enough on its own to ensure that advanced care wishes are available, as long-standing organisational and cultural issues, such as professionals working in silos and professional reluctance to have ‘end of life’ discussions, also need to be addressed.

AB - Electronic palliative care coordination systems (EPaCCS) detail preferred place of death across health and voluntary sector boundaries. Quantitative studies suggest that individuals recorded on EPaCCS are more likely to die at home. This study aimed to explore this relationship between EPaCCS and home deaths. Patient records from EPaCCS were collected from 1 September 2011 to 29 February 2012, linked to death data and analysed using descriptive statistics. We interviewed 101 professionals, including community nurses, and employed framework analysis. Few eligible patients were entered on EPaCCS (9% North Somerset, 13% Somerset). Of those, the majority died in community settings (87%, 81/93 North Somerset; 93% 307/331 Somerset). However, interviews and EPaCCS record analysis suggested that EPaCCS was almost exclusively used by community nurses and GPs, so, unsurprisingly, the relationship between EPaCCS and home deaths was strong. Difficulties included professional reluctance to discuss death, and the burden of data entry falling on daytime staff for out-of-hours colleagues. These results challenge assumptions that EPaCCS facilitates increased home deaths, as qualitative investigation identified selection bias. To avoid misinterpretations, future studies should employ mixed methods. The implementation of an electronic tool is not enough on its own to ensure that advanced care wishes are available, as long-standing organisational and cultural issues, such as professionals working in silos and professional reluctance to have ‘end of life’ discussions, also need to be addressed.

KW - end of life care

KW - EPaCCS

KW - home deaths

KW - palliative care

KW - preferred place of care

KW - preferred place of death

U2 - 10.1177/1744987116628922

DO - 10.1177/1744987116628922

M3 - Article

VL - 21

SP - 96

EP - 107

JO - Journal of Research in Nursing

JF - Journal of Research in Nursing

SN - 1744-9871

IS - 2

ER -

ID: 4664316