Abstract
Background: The Liverpool Care Pathway (LCP) is extensively used in hospices, but the literature on the process of implementation is scarce. Aim: Developing, piloting, and preliminarily assessing the LCP program within the inpatient hospice setting. Methods: This is a phase 0-1 study, according to the Medical Research Council (MRC) Framework, divided into three phases: literature review on LCP in hospice and development of the Italian version of the LCP program (LCP-I), development of a procedure for assessing the quality of the implementation process and assessing the feasibility of the implementation process, and piloting the procedure in 7 inpatient Italian hospices. Results: The LCP was implemented in all the hospices involved. A high proportion of physicians (50%-100%) and nurses (94%-100%) attended the self-education program. The self-implementation of the LCP-I program was completed in all hospices. The proportion of patients who died on LCP-I ranged between 35.6% and 89.1%. Professionals from 2 hospices reported a positive impact of the LCP-I. Conversely, professionals from 2 hospices did not recognize a positive impact of the program and did not agree to maintain the LCP-I in hospice. Finally, professionals from the other 3 hospices reported intermediate evaluations (1 stopped to use the LCP-I). Some weaknesses emerged from the external audits, related to the self-education and the self-implementation approach. Professionals required an external support from a trained palliative care team with reference to both phases. Conclusions: The LCP-I implementation within hospices is feasible, and the process of implementation is evaluable. Issues that occurred within the implementation process suggest the introduction of an external support from a trained palliative care team in implementing the LCP program.
| Original language | English |
|---|---|
| Pages (from-to) | 61-68 |
| Number of pages | 8 |
| Journal | American Journal of Hospice and Palliative Medicine |
| Volume | 31 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2014 |
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Keywords
- complex interventions
- dying
- End-of-life care
- hospice
- implementation process
- Liverpool Care Pathway
ASJC Scopus subject areas
- Medicine(all)
Cite this
Implementation of the Liverpool Care Pathway (LCP) for the Dying Patient in the Inpatient Hospice Setting : Development and Preliminary Assessment of the Italian LCP Program. / Leo, Silvia Di; Bono, Laura; Romoli, Vittoria; West, Emily; Ambrosio, Raffaella; Gallucci, Michele; Pilastri, Paola; Ciura, Pietro La; Morino, Piero; Piazza, Massimo; Valenti, Danila; Franceschini, Catia; Costantini, Massimo.
In: American Journal of Hospice and Palliative Medicine, Vol. 31, No. 1, 02.2014, p. 61-68.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Implementation of the Liverpool Care Pathway (LCP) for the Dying Patient in the Inpatient Hospice Setting
T2 - Development and Preliminary Assessment of the Italian LCP Program
AU - Leo, Silvia Di
AU - Bono, Laura
AU - Romoli, Vittoria
AU - West, Emily
AU - Ambrosio, Raffaella
AU - Gallucci, Michele
AU - Pilastri, Paola
AU - Ciura, Pietro La
AU - Morino, Piero
AU - Piazza, Massimo
AU - Valenti, Danila
AU - Franceschini, Catia
AU - Costantini, Massimo
PY - 2014/2
Y1 - 2014/2
N2 - Background: The Liverpool Care Pathway (LCP) is extensively used in hospices, but the literature on the process of implementation is scarce. Aim: Developing, piloting, and preliminarily assessing the LCP program within the inpatient hospice setting. Methods: This is a phase 0-1 study, according to the Medical Research Council (MRC) Framework, divided into three phases: literature review on LCP in hospice and development of the Italian version of the LCP program (LCP-I), development of a procedure for assessing the quality of the implementation process and assessing the feasibility of the implementation process, and piloting the procedure in 7 inpatient Italian hospices. Results: The LCP was implemented in all the hospices involved. A high proportion of physicians (50%-100%) and nurses (94%-100%) attended the self-education program. The self-implementation of the LCP-I program was completed in all hospices. The proportion of patients who died on LCP-I ranged between 35.6% and 89.1%. Professionals from 2 hospices reported a positive impact of the LCP-I. Conversely, professionals from 2 hospices did not recognize a positive impact of the program and did not agree to maintain the LCP-I in hospice. Finally, professionals from the other 3 hospices reported intermediate evaluations (1 stopped to use the LCP-I). Some weaknesses emerged from the external audits, related to the self-education and the self-implementation approach. Professionals required an external support from a trained palliative care team with reference to both phases. Conclusions: The LCP-I implementation within hospices is feasible, and the process of implementation is evaluable. Issues that occurred within the implementation process suggest the introduction of an external support from a trained palliative care team in implementing the LCP program.
AB - Background: The Liverpool Care Pathway (LCP) is extensively used in hospices, but the literature on the process of implementation is scarce. Aim: Developing, piloting, and preliminarily assessing the LCP program within the inpatient hospice setting. Methods: This is a phase 0-1 study, according to the Medical Research Council (MRC) Framework, divided into three phases: literature review on LCP in hospice and development of the Italian version of the LCP program (LCP-I), development of a procedure for assessing the quality of the implementation process and assessing the feasibility of the implementation process, and piloting the procedure in 7 inpatient Italian hospices. Results: The LCP was implemented in all the hospices involved. A high proportion of physicians (50%-100%) and nurses (94%-100%) attended the self-education program. The self-implementation of the LCP-I program was completed in all hospices. The proportion of patients who died on LCP-I ranged between 35.6% and 89.1%. Professionals from 2 hospices reported a positive impact of the LCP-I. Conversely, professionals from 2 hospices did not recognize a positive impact of the program and did not agree to maintain the LCP-I in hospice. Finally, professionals from the other 3 hospices reported intermediate evaluations (1 stopped to use the LCP-I). Some weaknesses emerged from the external audits, related to the self-education and the self-implementation approach. Professionals required an external support from a trained palliative care team with reference to both phases. Conclusions: The LCP-I implementation within hospices is feasible, and the process of implementation is evaluable. Issues that occurred within the implementation process suggest the introduction of an external support from a trained palliative care team in implementing the LCP program.
KW - complex interventions
KW - dying
KW - End-of-life care
KW - hospice
KW - implementation process
KW - Liverpool Care Pathway
UR - http://www.scopus.com/inward/record.url?scp=84893199923&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84893199923&partnerID=8YFLogxK
U2 - 10.1177/1049909113482355
DO - 10.1177/1049909113482355
M3 - Article
C2 - 23572178
AN - SCOPUS:84893199923
VL - 31
SP - 61
EP - 68
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
SN - 1049-9091
IS - 1
ER -