Strategies for the implementation of palliative care education and organizational interventions in long-term care facilities: A scoping review

Danni Collingridge Moore, Sheila Payne, Lieve Van den Block, Julie Ling, Katherine Froggatt, Yuliana Gatsolaeva, Elisabeth Honinx, Lara Pivodic, Rose Miranda, Bregje D. Onwuteaka-Philipsen, Hein van Hout, H. Roeline W. Pasman, Mariska Oosterveld-Vlug, Maud Ten Koppel, Ruth Piers, Nele Van Den Noortgate, Yvonne Engels, Myrra Vernooij-Dassen, Jo Hockley, Katarzyna SzczerbinskaMarika Kylanen, Giovanni Gambassi, Sophie Pautex, Catherine Bassal, Luc Deliens, Tinne Smets, Eddy Adang, Paula Andreasen, Ilona Baranska, Harriet Finne-Soveri, Teija Hammar, Rauha Heikkila, Violetta Kijowska, Suvi Leppaaho, Federica Mammarella, Martina Mercuri, Outi Kuitunen-Kaija, Agnieszka Pac, Emilie Morgan de Paula, Paola Rossi, Ivan Segat, Eleanor Sowerby, Jenny T. van der Steen, Agata Stodolska, Marc Tanghe, Anne B. Wichmann

Research output: Contribution to journalReview articleAcademicpeer-review

33 Citations (Scopus)


Background: The number of older people dying in long-term care facilities is increasing; however, care at the end of life can be suboptimal. Interventions to improve palliative care delivery within these settings have been shown to be effective in improving care, but little is known about their implementation. Aim: The aim of this study was to describe the nature of implementation strategies and to identify facilitators and/or barriers to implementing palliative care interventions in long-term care facilities. Design: Scoping review with a thematic synthesis, following the ENTREQ guidelines. Data sources: Published literature was identified from electronic databases, including MEDLINE, EMBASE, PsycINFO and CINAHL. Controlled, non-controlled and qualitative studies and evaluations of interventions to improve palliative care in long-term care facilities were included. Studies that met the inclusion criteria were sourced and data extracted on the study characteristics, the implementation of the intervention, and facilitators and/or barriers to implementation. Results: The review identified 8902 abstracts, from which 61 studies were included in the review. A matrix of implementation was developed with four implementation strategies (facilitation, education/training, internal engagement and external engagement) and three implementation stages (conditions to introduce the intervention, embedding the intervention within day-to-day practice and sustaining ongoing change). Conclusion: Incorporating an implementation strategy into the development and delivery of an intervention is integral in embedding change in practice. The review has shown that the four implementation strategies identified varied considerably across interventions; however, similar facilitators and barriers were encountered across the studies identified. Further research is needed to understand the extent to which different implementation strategies can facilitate the uptake of palliative care interventions in long-term care facilities.

Original languageEnglish
Pages (from-to)558-570
Number of pages13
JournalPalliative medicine
Issue number5
Publication statusPublished - 1 May 2020


  • Long-term care facilities
  • care homes
  • end-of-life care
  • implementation
  • intervention
  • literature review
  • nursing homes
  • palliative care
  • palliative medicine
  • scoping review

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