Teamwork, Continuity of Information Key to Identifying Palliative Care Needs in NH Residents

May 4, 2022

May 4, 2022
Contact: Ellen Mullally

Physicians are responsible for treatment decision-making, and nurses—who see nursing home residents more frequently—are best positioned to identify changes in condition. To be effective, this synergy requires consistent and ongoing communication and collaboration, the authors of an article in the May issue of JAMDA suggested.

Nurse-Physician Communication Around Identifying Palliative Care Needs in Nursing Home Residents involved a qualitative interview study aimed at assessing the experiences of nursing home staff medical practitioners about identifying emerging and changing palliative care needs of residents. As a result, the authors identified two important themes regarding nurse-physician communication: teamwork and continuity of information.

Teamwork, said the authors, involved dealing with team structure and dynamics. Specifically, they said, “The physicians often did not know the exact size and structure of the care team they were working with.” The researchers noted, “The quality of relationships within the team was facilitated by knowing each other both professionally and personally and may lower a threshold for nursing staff to consult the physician due to perceived hierarchical difference.” They also noted that disagreements complicated communication around identifying care needs, imposing an emotional burden on nursing staff.

Continuity of information, the authors observed, was “facilitated by effective routes of information; and face-to-face contact was seen as the most effective and primary route to communicate gradual deterioration.” However, practitioners interviewed for the study said that the quality of communicating observations was a concern, in particular communicating a “gut feeling” about residents with dementia, causing a hesitancy to consult the physician. “Nurses with more education communicated with the physicians directly but they may hear about changing needs second-hand,” the authors observed.

Interprofessional education may improve physician-nurse communication, the authors concluded: “Educating all staff and investing in relationships pay off when staff can be retained and can also help reduce staff turnover.”

The study was conducted by researchers at Leiden University Medical Center, Department of Public Health and Primary Care, Leiden, The Netherlands; Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, The Netherlands; Institute of Cultural Anthropology and Development Sociology, Leiden University, The Netherlands; Department of Public and Occupational Health, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands; and several others.

Get more information on the findings above and more details about the study. To contact the researchers or JAMDA editors for an interview, please email





JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit for more information.

About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.