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Liverpool Care Pathway: evaluation of a nationwide implementation program in the Netherlands.
Dekkers, A., Raijmakers, N., Galesloot, C., Heide, A. van der. Liverpool Care Pathway: evaluation of a nationwide implementation program in the Netherlands. European Journal of Palliative Care: 2013, p. 172-173. Abstract. In abstractbook. EAPC 2013. 13th World Congress of the European Association for Palliative Care (EAPC). 30 may - 2 june 2013, Prague.
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Introduction: The Dutch version of the Liverpool Care Pathway for the dying patient (LCP), Zorgpad Stervensfase, is a quality instrument for the care of dying people in the Netherlands. Since 2009 this pathway has been implemented nationwide in hospitals, nursing homes, hospices and homecare settings. Evaluation of this implementation program might show optimal strategies for implementing other quality instruments. Aim: Describe the implementation of the Dutch LCP and the most important facilitators and barriers from different stakeholders’ perspectives. Methods: We used quantitative and qualitative methods to get insight in the perspectives of stakeholders who were involved in the implementation process. In total 27 stakeholders were interviewed: 7 employees of the regional Comprehensive Cancer Centres (CCC), 8 palliative care network coordinators and 12 project leaders of successful implementation projects. Subsequently, we organized a focus group with the interviewees to discuss facilitators and barriers of implementation of the Dutch LCP. Results: Main reasons for institutions to implement Dutch LCP were to improve quality in end of life care, and to create a clear and uniform care plan at the end of life. Also extrinsic motivation was present, e.g. by financial incentives of insurance companies. Different successful strategies have been used for implementation of the LCP. Seven CCC´s trained local project leaders and supported them in different ways. Network coordinators especially played a role in informing institutions within their regions about the advantages of the Dutch LCP. Conclusions: In the dissemination process of the Dutch LCP a variety of strategies were used. Stakeholders identified shared facilitators and barriers, independent of chosen strategies. Knowing these facilitators and barriers can contribute to a successful implementation program, which is also of importance for other quality instruments in palliative care in the Netherlands.
Introduction: The Dutch version of the Liverpool Care Pathway for the dying patient (LCP), Zorgpad Stervensfase, is a quality instrument for the care of dying people in the Netherlands. Since 2009 this pathway has been implemented nationwide in hospitals, nursing homes, hospices and homecare settings. Evaluation of this implementation program might show optimal strategies for implementing other quality instruments. Aim: Describe the implementation of the Dutch LCP and the most important facilitators and barriers from different stakeholders’ perspectives. Methods: We used quantitative and qualitative methods to get insight in the perspectives of stakeholders who were involved in the implementation process. In total 27 stakeholders were interviewed: 7 employees of the regional Comprehensive Cancer Centres (CCC), 8 palliative care network coordinators and 12 project leaders of successful implementation projects. Subsequently, we organized a focus group with the interviewees to discuss facilitators and barriers of implementation of the Dutch LCP. Results: Main reasons for institutions to implement Dutch LCP were to improve quality in end of life care, and to create a clear and uniform care plan at the end of life. Also extrinsic motivation was present, e.g. by financial incentives of insurance companies. Different successful strategies have been used for implementation of the LCP. Seven CCC´s trained local project leaders and supported them in different ways. Network coordinators especially played a role in informing institutions within their regions about the advantages of the Dutch LCP. Conclusions: In the dissemination process of the Dutch LCP a variety of strategies were used. Stakeholders identified shared facilitators and barriers, independent of chosen strategies. Knowing these facilitators and barriers can contribute to a successful implementation program, which is also of importance for other quality instruments in palliative care in the Netherlands.