What do hospitalists experience as barriers and helpful factors for having ACP conversations? A systematic qualitative evidence synthesis:

Background:Hospitalists seem to struggle with advance care planning implementation. One strategy to help them is to understand which barriers and helpful factors they may encounter.Aims:This review aims to give an overview on what hospitalists experience as barriers and helpful factors for having advance care planning conversations.Method:A systematic synthesis of the qualitative literature was conducted.Data sources:A bibliographic search of English peer-reviewed publications in PubMed, Embase, CINAHL, Central, PsycINFO, and Web of Science was undertaken.Results:Hospitalists report lacking communication skills which lead to difficulties with exploring values and wishes of patients, dealing with emotions of patients and families and approaching the conversation about letting a patient die. Other barriers are related to different interpretations of the concept advance care planning, cultural factors, like being lost in translation, and medicolegal factors, like fearing prosecution. Furthermore, hospitalist...