Health professionals' and leaders' views on routine using patient-centered outcome measures in a Chinese palliative care unit: A qualitative study.

Background: A person-centered outcomes-based quality improvement program is lacking within palliative care in Mainland China. The well-established Australian Palliative Care Outcome Collaboration (PCOC) national model improves palliative care quality.

Objectives: This study aimed to explore the barriers and facilitators perceived by healthcare providers to integrating the PCOC model in a Chinese hospital-based palliative care unit.

Methods: A qualitative descriptive study was conducted using semi-structured focus group and individual interviews. A rapid deductive analysis approach was selected for data analysis. The Consolidated Framework for Implementation Research framework was used to guide the study design, data collection, analysis, and interpretation.

Results: Eighteen healthcare professionals participated in this study, four focus group interviews and five individual interviews were completed. Barriers to the PCOC integration included clinical application and workload concerns (patients in terminal stage, patients' dialects, workload concerns, and staff shortages); attitudinal barriers (negative attitudes toward PCOC); psychological barriers (numbness to their work) and barriers related to knowledge and self-efficacy (lack of knowledge, capacity, and self-efficacy in palliative care). Facilitators included adapting the program to local contexts, ongoing education and feedback, effective PCOC data use, a supportive work and clinical environment and staff's perceived advantages of the model across clinical, research and process domains.

Significance of results: The successful integration of the PCOC program hinges on local adaptation, improved data utilization, education, and IT support. In regions with less developed palliative care, enhancing professionals' knowledge and self-efficacy is crucial. Incorporating assessment and clinical response protocols into technology can accelerate palliative care development and implementation.