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Table 1 Focus group discussion results

From: “Building palliative care capacity in cancer treatment centres: a participatory action research”

Probes

Responses

Recommendations

How can we improve capacity for palliative care within oncology institutes?

Identify change champions for palliative care

• A team of 2 doctors and 2 nurses from each oncology institute to drive the organizational change

Improve Infrastructure

Space, staff, time, equipment

• Stand-alone outpatient palliative care department

• Consultation liaison service for inpatients

• Task shifting to overcome health workforce shortage

• Prevent task overload

Increase access to opioids

• Procure license to store and dispense opioids

• Educate regarding safe practices

• Ensure uninterrupted supply

Initiate advocacy activities to raise awareness about PC

• Develop competency for in-house training

• Conduct continuing medical education programs with external support

How can we improve individual capacity to provide palliative care in oncology treatment institutes?

• Improve knowledge and skills about palliative care

• Help in knowledge translation

• Attend and complete recommended training in palliative care

• Mentoring activities

• Academic detailing

• Develop institutional policies and guidelines

What are the outcome indicators to measure the implementation of the program?

For organizational capacity building

• Number of dedicated staff for palliative care

• Number of hours of OPD per month

• Number of patients seen in OPD per month

• Number of patients seen in CL per month

• Number of new patients referred to palliative care

For individual capacity building

• 5-day face-to-face training in Palliative Care

• 5-day clinical attachment at specialist palliative care institute

• 2-day mentorship training by a visiting mentor

• Completion of certificate course in essentials of palliative care (CCEPC) by Indian Association of Palliative Care

For morphine availability

• Number of milligrams of morphine use per month

For advocacy activities

• Number of trainings conducted in a year

• Number of doctors trained

• Number of nurses trained

• Number of allied healthcare practitioners trained

• Observance of World Hospice and Palliative Care Day in the institute