Table 2 Summary of Themes

Changes in practice or knowledge derived from CAPACITI

Ways in which CAPACITI changed (or did not change) team thinking or practice

Early identification

Changes in identifying patients who could benefit from palliative care earlier in the disease trajectory

Communication skills

Changes to communication skills within teams and with patients

Applying a palliative approach to care

General changes in applying a palliative approach to care in practice

Improved teamwork

Changes in collaborative efforts in palliative care both within teams and through outreach to external providers

Utility of CAPACITI components

The perceived utility of specific elements of CAPACITI.

Monthly assignments

Optional exercises for teams to become acquainted with applying CAPACITI components in practice, e.g. creation of a palliative care registry

Cheat sheet

Summary of core lessons from CAPACITI on an easy-to-reference handout

Mentorship

Consultation with an assigned palliative care expert external to team organizations to assist with learning outcomes

Barriers and challenges to enacting CAPACITI in practice

Internal (team- or context-based) factors caused teams to struggle with applying CAPACITI learnings in their practice

COVID-19 pandemic

Impact of the pandemic on completing CAPACITI, e.g., move to virtual-only meetings, balancing increased workload demand

Competing demands

Time constraints in completing CAPACITI components, coordinating schedules between time zones, or difficulty in scheduling mutually available times within teams

Team fragmentation

Lack of team integration, funding restrictions, and distal proximity of team members

Lack of confidence or opportunities to practice

Low individual/team comfort levels in providing palliative care, low volume of seriously ill patients to apply CAPACITI learnings

System-based challenges

Geographic limitations of access to care, system fragmentation, and a lack of team integration