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Regional hospice and palliative care networks (RHPCNs), consisting of collaboration and coordination in a specific geography amongst various healthcare professionals, organisations and community resources at a structural level, have emerged to enhance the delivery of comprehensive and integrated care for patients with life-limiting illnesses.
RHPCNs differ from coordination amongst individual providers in that they are coordinated at the structural or organizational level. With the increase of RHPCNs around the world, an better understanding of their structures, benefits and success factors will help guide further development.
To help advance this understanding, and colleagues (2024), conducted a scoping review to map the literature on RHPCNs. The specific research questions included: What is known about RHPCNs worldwide, with regard to (a) their structure, (b) their benefits and outcomes, and (c) their success factors and good practices?
The review included research studies describing networks working at the structural level in hospice and palliative care settings, published in English or German.
A total of 24 articles met the inclusion criteria and were included in the study, of which 10 were based in Canada. The results are presented in the three categories aligned with the research questions:
Structures
- Network Role – Generally, the role of the network is to contribute to collaboration and efficient delivery of patient-centered care. Studies also identified a network role in sustaining interprofessional collaboration, a central point of information exchange,
- Organizational Structure – Different organisational models, based on various forms of cooperation were identified, including: cooperation agreements, cooperation via coordination offices or steering committees, and cooperation with no formal agreement in place but the intention to share costs.
Outcomes and Benefits
- Professional Practice Benefits – Interdisciplinary collaboration and a team-based approach can lead to improved coordination and communication; integration of bereavement and pain management contributes to holistic patient care; networking can improve ethical awareness and knowledge of legislation; and improvements in symptom management and the introduction of regional standardised assessment procedures can improve patient care.
- Client Service Benefits – Studies reported increased client benefits through improved professional practices; better communication and coordination amongst professionals; a reduction in emergency visits; and introduction of evidence-based best practices.
Success Factors and Good Practices
Several success factors were identified, including:
- Effective leadership and governance structures, providing clear direction, commitment and the ability to navigate complex dynamics.
- Streamlined care coordination, standardised practices and centralised capacities.
- Transparency and trust as critical factors for fostering effective relationships between stakeholders.
- Flexibility and adaptability of the network.
- Sustainable resource management, including financial considerations and incentives
- Provision of bereavement support.
- Education and training programmes for healthcare professionals.
- Community engagement, outreach and the promotion of public awareness.
The findings of this scoping review may be used as a guide for RHPCNs to strengthen their ability to provide effective and integrated end-of-life care. Further, the findings may be used by policymakers to improve the structural frameworks and funding conditions of RHPCNs.
Source: Röwer, H. A., Herbst, F. A., & Schwabe, S. (2024). Regional hospice and palliative care networks worldwide: scoping review. BMJ Supportive & Palliative Care.
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