Table 2 Definitions of various models or components thereof for palliative care delivery found in the literature

Case management

Case management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s holistic needs through communication and available resources to promote quality cost effective outcomes. The definition of case management notes the focus upon the meeting of a client’s health needs. Case management can be placed within a social model of health, within which improvement in health and well-being are achieved by directing efforts towards addressing the social and environmental determinants of health, in tandem with biological and medical factors [31].

Consultation model

An approach to care by which specialist advice is provided on assessment and treatment of symptoms, communication about goals of care and support for complex medical decision-making, provision of practical and psychosocial support, care coordination and continuity, and bereavement services when appropriate [37]. Advice is provided without necessarily assuming primary responsibility for care, although there is negotiation of the level of palliative care involvement.

Health or clinical networks

Health networks are formed when three or more health care agencies (services, organisations or health districts) formally come together to better meet the needs of patients in their service area. These agencies often include hospitals, community health centres, critical access hospitals, physician practices, mental health providers, rural health clinics and other for-profit and not-for-profit health care organizations. These health or clinical networks work to increase access to quality healthcare for local patients and streamline the cost of that care, as well [38].

Integrated care

Integrated care is a concept bringing together inputs, delivery, management and organisation of services relating to diagnosis, treatment, care, rehabilitation and health promotion. Integration is a means to improve the services in relation to access, quality, user selection and offering care [39].

Liaison model

The liaison model combines the education of patients after discharge with educational outreach and clinical support for primary care clinicians. This model may be particularly appropriate in deprived areas, where general practices vary in their capacity to manage chronic illness [40].

Managed clinical networks (MCNs)

Clinical networks are linked groups of health professionals and organisations from primary, secondary, and tertiary care working in a coordinated manner, unconstrained by existing professional and [organisational] boundaries to ensure equitable provision of high quality effective services [21]. MCNs address many of the problems that have been identified in the traditional delivery of health services, including: poor coordination and collaboration between health services; changing roles for health professionals; and the need for greater efficiencies, improved access, more equitable service provision, better use of limited resources and quality patient-centred care. More specifically, MCNs aim to develop locally delivered, quality assured care, through the managed integration of, and cooperation between, formerly separate clinical services. Their major focus is on actively involving patients in service design and building seamless services around the patient’s journey to ensure the best treatment gets to the right patient, at the right time, in the most appropriate place and is delivered by the most qualified and skilled professional with the greatest resources [22].

Pop-up model

Often palliative needs in rural areas may be intermittent or needs specific. Developing a permanent infrastructure would not be appropriate in these circumstances. Looking at available local resources and gaps would provide a basis for developing a ‘pop-up’ palliative service model that optimises how local resources and services can be used to respond to a specific palliative need [24].

Shared care model

A review [28] suggests that three definitions of shared care have been offered:

1. An approach to care which uses the skills and knowledge of a range of health professionals who share joint responsibility in relation to an individual’s care. This also implies monitoring and exchanging patient data and sharing skills and knowledge between disciplines.

2. A narrower approach concerned with joint participation of general practitioners and specialists in the planned delivery of care for patients with a chronic condition, informed by an enhanced information exchange, over and above the routine discharge and referral letters.

3. Especially in mental health, shared care can be divided into systematic cooperation about how systems agree to work together and operational cooperation at local levels between different groups of clinicians.