Next Article in Journal
Cost–Utility of Adjuvant Zoledronic Acid in Patients with Breast Cancer and Low Estrogen Levels
Previous Article in Journal
Is It Time to Offer BRCA1 and BRCA2 Testing to All Jewish Women?
 
 
Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Advance Care Planning: Identifying System-Specific Barriers and Facilitators

1
Departments of Oncology, Clinical Neurosciences, and Medicine, University of Calgary, Calgary, AB, Canada
2
Division of Cardiology, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
3
Department of Oncology, University of Calgary, Calgary, AB, Canada
4
Departments of Medicine and Community Health Science, University of Calgary, Calgary, AB, Canada
5
Department of Oncology, University of Alberta, and Covenant Health Palliative Institute, Edmonton, AB, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2015, 22(4), 237-245; https://0-doi-org.brum.beds.ac.uk/10.3747/co.22.2488
Submission received: 5 May 2015 / Revised: 6 June 2015 / Accepted: 12 July 2015 / Published: 1 August 2015

Abstract

Background: Advance care planning (acp) is an important process in health care today. How to prospectively identify potential local barriers and facilitators to uptake of acp across a complex, multi-sector, publicly funded health care system and how to develop specific mitigating strategies have not been well characterized. Methods: We surveyed a convenience sample of clinical and administrative health care opinion leaders across the province of Alberta to characterize system-specific barriers and facilitators to uptake of acp. The survey was based on published literature about the barriers to and facilitators of acp and on the Michie Theoretical Domains Framework. Results: Of 88 surveys, 51 (58%) were returned. The survey identified system-specific barriers that could challenge uptake of acp. The factors were categorized into four main domains. Three examples of individual system-specific barriers were “insufficient public engagement and misunderstanding,” “conflict among different provincial health service initiatives,” and “lack of infrastructure.” Local system-specific barriers and facilitators were subsequently explored through a semi-structured informal discussion group involving key informants. The group identified approaches to mitigate specific barriers. Conclusions: Uptake of acp is a priority for many health care systems, but bringing about change in multi-sector health care systems is complex. Identifying system-specific barriers and facilitators to the uptake of innovation are important elements of successful knowledge translation. We developed and successfully used a simple and inexpensive process to identify local system-specific barriers and enablers to uptake of acp, and to identify specific mitigating strategies.
Keywords: advance care planning; goals of care designation; knowledge translation advance care planning; goals of care designation; knowledge translation

Share and Cite

MDPI and ACS Style

Hagen, N.A.; Howlett, J.; Sharma, N.C.; Biondo, P.; Holroyd-Leduc, J.; Fassbender, K.; Simon, J. Advance Care Planning: Identifying System-Specific Barriers and Facilitators. Curr. Oncol. 2015, 22, 237-245. https://0-doi-org.brum.beds.ac.uk/10.3747/co.22.2488

AMA Style

Hagen NA, Howlett J, Sharma NC, Biondo P, Holroyd-Leduc J, Fassbender K, Simon J. Advance Care Planning: Identifying System-Specific Barriers and Facilitators. Current Oncology. 2015; 22(4):237-245. https://0-doi-org.brum.beds.ac.uk/10.3747/co.22.2488

Chicago/Turabian Style

Hagen, N.A., J. Howlett, N.C. Sharma, P. Biondo, J. Holroyd-Leduc, K. Fassbender, and J. Simon. 2015. "Advance Care Planning: Identifying System-Specific Barriers and Facilitators" Current Oncology 22, no. 4: 237-245. https://0-doi-org.brum.beds.ac.uk/10.3747/co.22.2488

Article Metrics

Back to TopTop