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Table 8 Interdisciplinary working patterns (co-working)

From: Palliative care specialists’ perceptions concerning referral of haematology patients to their services: findings from a qualitative study

Working ‘in tandem’ or intermittently
‘getting the palliative care professionals involved quite early, um, so that you’ve got this nice long overlap between the haematology…and the palliative care input so that eventually when somebody is discharged or isn’t being followed up as regularly by the haematologists, they know they are supported by the palliative care team already.’ (SPC doctor 4)
‘I think we can be involved…and then the patient changes, deteriorates, so we go back in, we sort it out, we come out again…so we have sort of several episodes of care within that journey of care, dependent on what their needs are’ (SPC nurse 5)
Co-working and visibility
‘the palliative care team attend weekly MDTs, so communication is very good’ (SPC nurse 3)
‘working in partnership with the [haematologists] helps… I think the ward rounds, being that visible person in the ward round, where you can pre-empt some things and then prompt them’ (SPC nurse 5)
‘our relationship is really good…we couldn’t go for a period to the ward rounds and referral started to drop off…it’s about our visibility…if we’re there it reminds them that actually they can ask our advice and referrals go up, when we’ve got a high profile, referrals go up’ (SPC nurse 13)
‘the (haematology) consultants here, I have a very good working relationship with them, and I know I can pick up the phone and say, “I’ve seen your patient on the ward today and they’ve expressed these concerns”’ (SPC nurse 14)
‘now it’s a big thing, because referring on to palliative care means you’re [patient] going to be dead in two days… whereas if you’re seen and perceived to be working much closer together, as an integrated team involved from earlier on… then it’s no big deal…’ (SPC doctor 1)
‘we’re quite fortunate in that most of the haematologists are always down this corridor so quite often they will actually pop into our office and talk to us about patients…as well as the ward round, there is that informal opportunity for talking about patients’ (SPC nurse 13)
Growing collaboration between palliative care and haematology specialists
‘I have to say, in the past 10 years, communication [between teams] has improved quite significantly…so that’s obviously been a change for the better’ (SPC nurse 14)
we’ve [SPC nurses] got very close relationships with the haematology wards…there’s a group of us who cover those wards so we’ve built up relationships and they know who we are and they refer to us directly’ (SPC nurse 14)
‘the more time we spend with the haematologists and the more relationships that we build up, the more patients of theirs they refer to us that we help, then the better the relationship gets. It’s all about relationship building. We’re learning about their specialty as much as they’re learning about us and it’s just about shared understanding I think…we have a joint clinic once a week…influencing decision making patient by patient…you’re seen as more as part of the team’ (SPC doctor 6)