Palliative Care and Advance Care Planning Intervention Fidelity Monitoring

被引:0
|
作者
Verma, Manisha [1 ]
Grudzen, Corita R. [2 ]
Izumi, Seiko [3 ]
Wenger, Neil [4 ]
El-Jawahri, Areej [5 ]
Ejem, Deborah [6 ]
Aslakson, Rebecca A. [7 ]
机构
[1] Thomas Jefferson Univ, Jefferson Einstein Hosp, Dept Med, Philadelphia, PA USA
[2] Mem Sloan Kettering Canc Ctr, New York, NY USA
[3] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR USA
[4] Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA
[5] Massachusetts Gen Hosp, Div Hematol Oncol, Boston, MA USA
[6] Univ Alabama Birmingham, Sch Nursing, Birmingham, AL USA
[7] Univ Vermont, Med Ctr, Dept Anesthesiol, Burlington, VT USA
关键词
palliative care; advance care planning; adaptations; implementation; fidelity monitoring; COMPLEX INTERVENTIONS; CANCER; QUALITY; TRIAL;
D O I
10.1097/MLR.0000000000002037
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Over the past decade, the Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale, comparative effectiveness clinical trials evaluating palliative care and advance care planning interventions. These are complex multicomponent interventions that need robust but flexible fidelity monitoring. Fidelity is necessary to maintain both internal and external validity within palliative care intervention research and to ultimately evaluate the real-world impact of high-quality interventions. Different trials not only took varying approaches to fidelity monitoring but also uncovered both unique and common challenges and facilitators. This article summarizes 8 of these trials and highlights approaches, adaptations, barriers, and facilitators for intervention fidelity monitoring. Identifying and delivering core elements while simultaneously allowing adaptations of noncore elements is a vital part of fidelity monitoring. Dissemination of such experiences can inform both future palliative care research as well as ongoing implementation of palliative care and advance care planning interventions across diverse clinical practices. Adoption of rigorous intervention fidelity methods is critical to advancing the science and reproducibility of palliative care interventions.
引用
收藏
页码:680 / 692
页数:13
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