to sell this to the organization, part of what you have to sell is how
it needs to be done: how slowly it needs to start, what kinds of resources
need to be committed, what needs to be done for team
building, because trust us, it will pay off down the road. It will run
smoothly and all of these things that contribute to poor patient
management will be alleviated. That’s something that they should
take advantage of if they’re going to replicate this kind of model.
Another resource need identified was staffing. Staffing, in terms of
the staff time allocated for work on this project, remained a major issue
at both the home site (to provide guidance, supervision and training)
and replication sites throughout the program implementation process.
Both care teams note that fluctuations in staffing needs sometimes created
chaotic circumstances wherein outside staff had to be pulled in to
meet unanticipated care needs, with uneven results. They were also
frustrated by the fact that their team composition kept changing and that
this sometimes meant working with clinicians who had no experience
providing end-of-life care.