From Late Access to Early Identification: A Community Nursing Model for Activation of the Palliative Care Network

Abstract

Introduction. Late access to palliative care networks represents a significant issue in community settings, often due to the lack of a structured process for the early identification and referral of palliative care needs. This delay compromises the timeliness of care and the overall quality of assistance. In this context, the nursing role is strategic but remains underutilized.

Methods. A community-based organizational model was developed and formalized through the integration of validated tools for the early identification of palliative care needs (NECPAL) and the assessment of care complexity (IDC-PAL). The model defines a structured pathway encompassing identification of needs, referral, assessment, and care provision, and was formalized through an organizational procedure and specific operational instructions.

Results. The model made the process of accessing the palliative care network explicit, increasing entry points and improving integration among healthcare professionals. It also defined an active role for nurses in the early identification and referral of patients with palliative care needs, with the potential to improve the timeliness of care.

Discussion. The introduction of a structured access model represents a key strategy for overcoming delays in palliative care activation. Strengthening the nursing role enables earlier identification of care needs in community settings and may improve continuity and quality of care. The proposed model is potentially replicable in other healthcare settings.