# “I don’t think service changed, I think people changed”: Palliative care delivery in Aotearoa/New Zealand after COVID-19

## TL;DR

This study explores how and why palliative care services in New Zealand adapted during and after the COVID-19 pandemic, focusing on changes in communication, collaboration, and patient-centered care.

## Contribution

The study identifies the motivations behind sustained changes in palliative care delivery, emphasizing patient-centered innovation and Indigenous empowerment.

## Key findings

- Health professionals adapted by streamlining policies, using technology, and building collaborative relationships.
- Motivations for changes included increased competence, stronger relationships, and greater autonomy in care delivery.
- Findings highlight the importance of patient-centered care and Indigenous empowerment in sustaining post-pandemic innovations.

## Abstract

As a result of COVID-19 restrictions, palliative care services in New Zealand and across the world needed to adapt rapidly and creatively to find new ways of working, revising, and establishing new policies and practices. This article reports the findings of phase I of an 18-month study examining changes in hospice care delivery in Aotearoa/New Zealand in the wake of COVID-19.

This study aimed to explore the motivations underpinning adaptations and innovations in the delivery of palliative care in the wake of COVID-19.

Transdisciplinary Action Research and Partnership approaches were utilised.

A thematic analysis was conducted of open-ended telephone, video, and in-person questionnaire data collected from January to August 2024 from a diverse group of stakeholders. Our findings explored the motivations for health professional practice changes in the realms of competence, relationships, and autonomy.

Changes in behaviour involved streamlining and adapting policies and services, using technology to facilitate communication, building collaborative connections, and activating health professionals, families, and Indigenous empowerment.

Palliative care services needed to adapt rapidly and creatively to the threats posed by COVID-19. The threats posed were a motivator to shift thinking about palliative care delivery regarding services, relationships, and empowerment. This shift in thinking led to changes in ways of working, revising, and establishing new policies and practices. The driving force underpinning the changes and innovations is the desire to provide patient-centred care. Indeed, the findings build a case for patient-centred, sustainable, and effective innovation. From the perspective of health professionals, the findings may inform strategies to sustain new practices in delivering quality palliative care. Additionally, they may also provide insights into possible methods to grow individual and community capacity to face future pandemics.

Palliative care delivery in Aotearoa/New Zealand after COVID-19

Why was the study done? The study was done to understand why some changes made to palliative care services during the COVID-19 pandemic were kept even after the pandemic ended. Health services had to adapt quickly, and the researchers wanted to explore why these changes continued.

What did the researchers do? The researchers interviewed 37 professionals, including health workers and managers in hospice organizations in Aotearoa New Zealand, and worked with a Māori researcher to include the views of Māori communities.

What did the researchers find? The study found that changes included improving services, using technology for better communication, working together more, and promoting independence for families and Indigenous people. The reasons these changes stuck were linked to factors like feeling more skilled, building better relationships, and having more control over work.

What do the findings mean? The findings indicate the importance of patient-centred care. They help us understand what motivates health professionals to keep using new ways of providing palliative care and how to support them in maintaining these changes.