Research looks at palliative care services in hospitals

In more and more hospitals across the U.S., patients turn to palliative care specialists to provide relief from pain, help in making difficult medical decisions and support for their families and those who care for them.

How well do these services work? What barriers inhibit these services in a hospital and what assists their delivery?

A team of researchers, led by a University of Rochester School of Nursing professor, has received a $1.4 million grant from the National Institutes of Health to investigate these and other questions.

"Palliative care consultations are a relatively new kind of health care service in the acute hospital setting," says Sally Norton, Ph.D., R.N., an assistant professor in the UR nursing school who is the project’s principal investigator. "The palliative care service model grew out of the hospice setting. That’s a very different culture than a hospital."

The goals of the project include analyzing the meeting of the two cultures and examining palliative care experiences from the perspective of patients, families, referring physicians and the providers of palliative care.

"We can explain palliative care in theory but we want to nail down how it is done, what works and what doesn’t work," Norton says.

The study will give researchers and health care providers a better understanding of the evolving nature of palliative care, which will help develop more effective consultation in the acute care setting, Norton says.

Palliative care services for the seriously ill include managing pain and other symptoms, maintaining open communication between patients and health care providers and helping patients explore options for treatment.

The National Institute of Nursing Research awarded the four-year grant.

This ethnographic study will involve intensive observation of palliative care services in hospital settings and detailed interviews. The work, which will begin in the fall, primarily will be conducted at the UR medical center.

The other investigators in the research project are: Judith Gedney Baggs, Ph.D., R.N., associate dean for academic affairs at the UR School of Nursing; Madeline Schmitt, Ph.D., R.N.; Mary Dombeck, Ph.D., D. Min, R.N.; and Timothy Quill, M.D., head of the Center for Palliative Care and Clinical Ethics at the UR medical center.