Table 2 Effective Practice and Organisation of Care (EPOC) Taxonomy “Implementation Strategies” and “Financial Arrangements” Fitting the “Taking Care of You” (TCY) Program Strategy and Objectives
Subcategory | TCY strategy | Strategy objective |
|---|---|---|
Implementation Strategies Interventions designed to bring about changes in healthcare organizations, the behavior of healthcare professionals or the use of health services by healthcare recipients | ||
Category: Interventions targeted at healthcare workers | ||
A. Communities of Practice | Local advocacy to convene capacity building | Train a specialized PPC team through graduate programs abroad |
B. Educational Materials | Design and create written, and online evidence-based information material | Supply healthcare professionals with key objective topics and information on PPC |
C. Educational Meetings | Local, and national educational courses and workshops | Create a successful method to favor mass training and raising awareness on PPC approach and principles for healthcare professionals |
D. Interprofessional Education | Coach national multidisciplinary courses and participation in postgraduate university courses | Increase national multidisciplinary knowledge on palliative philosophy |
E. Patient-Mediated Interventions | Medical, psychological and social work evaluation of the patient and family to discuss as part of multidisciplinary medical board meetings | Provide a psychosocial and medical perspective of the patient and family prior to multidisciplinary decision-making meetings |
Financial Arrangements Changes in how funds are collected, insurance schemes, how services are purchased, and the use of targeted financial incentives or disincentives | ||
Category: Collection of funds | ||
F. External Funding | Apply for funding through a research grant | Promote and sustain pediatric palliative care in a middle-income country |
Category: Insurance schemes | ||
G. Community-Based Health Insurance | Held Advocacy Reunions with health care providers locally | Lower access barriers for patients and families of MIC |
Category: Mechanisms for the payment of health services | ||
H. Payment Methods for Health Workers | Reunions with the board of directors and decision-makers emphasizing the added value of PPC, based on enhancing patient and family satisfaction, patient experience, health humanization, and resource optimization | Obtain institutional support to consolidate the team and decrease the access barrier |
Delivery Arrangements Changes in how, when, and where healthcare is organized and delivered, and who delivers healthcare. | ||
Category: Where care is provided and changes to the healthcare environment | ||
I. Site of service delivery | Promote patient attention in the outpatient scenario through medical order | Since most of the patients are referred to the program from hospitalization, we make sure they can continue attention in the outpatient ward |
Category: Who provides care and how the healthcare workforce is managed | ||
J. Role expansion or task shifting | Coached local interdisciplinary team meetings, educational meetings among the general PC group. | Guide the conformation of the Pediatric Palliative Care team |
Category: Coordination of care and management of care processes | ||
K. Care pathways | Held institutional multidisciplinary meetings with local health care providers | Contextualize life-limiting-and-threatening disease |
L. Case management | Participated in multidisciplinary board meetings with treating specialist and several homecare services | Coordinate and guarantee an integrative followup to improve patients care |
M. Communication between providers | Coached local interdisciplinary team meetings, support for clinical improvement plans of the team and regional educational meetings | Facilitating and establishing communication and developing an improved dialogue. |
N. Continuity of care | While in hospitalization we hold medical board meetings with interdisciplinary teams and promote continuity through outpatient setting followup | Ensuring the responsibility of care and bereavement followup |
O. Disease management | Coached educational team meetings, regional meetings with health care professionals and healthcare providers | Promote adequate quality of life during the health-disease-attention process |
P. Patient-initiated appointment systems | Providing phone advisory 24 h 7 days a week | Around-the-clock availability for care consultation to direction the family and bereavement care |
Q. Referral systems | Coached educational sessions with the hospital’s pediatric departments | Educating about the importance of involving comprehensive care and patients with complex chronic diseases who are candidates for referral to the PPC team |
R. Shared decision-making | Meetings and constant communication is held with TCYteam, treating specialist and the family | Establish individualized management goals |
S. Teams | Coached local interdisciplinary team meetings, support for clinical improvement plans, and regional educational meetings | Establishing a multidisciplinary team that provides organizational status, coordinated care, and capability based on individualized relevance and effectivity |
T. Transition of Care | Interdisciplinary meetings between treating specialist, our team and the family | Provide objective information to the family when a patient’s treatment changes from curative to palliative |