What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

S.M.C. Ament, L.M. van den Broek, M.H.J. Van den Beuken-van Everdingen, J.J.J. Boyne, J.M.C. Maessen, S.C.A.M. Bekkers, L. Bellersen, H.P. Brunner-La Rocca, Y. Engels, D.J.A. Janssen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.
Original languageEnglish
Article number1
Number of pages9
JournalBMC Palliative Care
Issue number1
Publication statusPublished - 4 Jan 2022


  • End-of-life
  • Palliative medicine
  • Congestive heart failure
  • Implementation

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