Researcher Spotlight - Peter O'Halloran

Involving patients and their families in decisions about their care

Peter O’Halloran’s research centres on involving patients and their families in decisions about their care – especially individuals with chronic or life-limiting conditions. After a twenty-year career as a clinical nurse, Peter gained a doctorate in health services research and has been a lecturer in the School since 2003. He has always been fascinated by why things work (or sometimes don’t work) in the real world of health care, so his research focuses on developing models of good practice to guide professionals and health care organisations. ‘I worked with Dr Tracey McConnell on a project looking at the Liverpool Care Pathway for the Dying Patient – an approach to caring for people at the end of life that generated a lot of controversy. We were able to identify a number of factors that contributed to the failure of the pathway, which are still relevant to care for the dying in the health service.’

One of the problems identified by the research was that very ill patients and their families were not having conversations with doctors and nurses about what they would like to happen if their condition worsened. This led to the next phase of the research: investigating advance care planning. ‘An advance care plan is simply a process where a patient and their family discuss their future care with the health professionals looking after them. Then the plan can be used to help guide care if the patient is unable to speak for themselves.’ Peter got together with co-workers Helen Noble and Kevin Brazil, nurses and doctors in local hospitals, colleagues from the Centre for Public Health at Queen’s, and internationally recognised experts in London and Sydney, to develop a research proposal which has now been funded by the Dunhill Medical Foundation, a major UK charity. ‘We’re going to look at advance care planning with patients who are on kidney dialysis. It’s exciting but also challenging because we will be breaking new ground with our clinical colleagues and hopefully fully involving patients and their families in planning their future care.’

Side-by-side with his work with older people, Peter has also developed research with children and young adults. For the last three years he has been working with Helen Kerr, a research fellow funded by the All Ireland Institute of Hospice and Palliative Care who is based in the School, on a project investigating how young people in Ireland with life-limiting conditions make the transition from children’s to adult health services – a vital step in their care. ‘We found that one of the most important things for a successful transition for a young person with a condition like muscular dystrophy or cystic fibrosis, is that they are fully involved in decisions about their care and communicate well with health professionals. It got me thinking about how we could help young people do that more effectively.’

To grapple with these issues, Peter brought together a team which includes colleagues from the School of Sociology and Social Policy at Queen’s, the University of Ulster, the Royal College of General Practitioners and a young adult with a life-limiting illness. The team has obtained funding from Marie Curie Research to look at how young people with life-limiting conditions can benefit from something called a “Healthcare Passport” – a sort of patient-held record which is intended to help them communicate well with health professionals. ‘Again, it’s exciting and challenging,’ says Peter, ‘and it’s all part of helping patients and their families become fully involved in decisions about their care.’