METHODS
Approximately 18 months after the initiation of the Palliative Care
study within the two managed care sites, a qualitative process study was
undertaken to identify institutional and programmatic barriers and facilitators
experienced during the replication of the model. Toward this
end, the evaluator conducted three focus groups with care team members
who were directly involved with the implementation of the IPCP at
each site. The dialogue in these groups focused on care team members’
reflections on the process of implementing such a program, their impressions
of the training and ongoing support that they received from
the home site during the implementation process, and their suggestions
for replication of the model at future sites.
The evaluator conducted 11 individual interviews with oncologists,
pulmonologists and internal medicine physicians. Specific efforts were
taken to ensure inclusion of physicians and specialists making both low
and high volumes of referrals to the program. These open-ended, structured
interviews focused on eliciting physician perceptions as to the
structural and experiential barriers and facilitators to the referral process
and their suggestions for improving that process.