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. 2014 Sep 17:14:396.
doi: 10.1186/1472-6963-14-396.

Consensus on quality indicators to assess the organisation of palliative cancer and dementia care applicable across national healthcare systems and selected by international experts

Jasper van Riet Paap  1 , Myrra Vernooij-Dassen, Rose-Marie Dröes, Lukas Radbruch, Kris Vissers, Yvonne Engels; IMPACT research team
Affiliations

Consensus on quality indicators to assess the organisation of palliative cancer and dementia care applicable across national healthcare systems and selected by international experts

Jasper van Riet Paap et al. BMC Health Serv Res. .

Abstract

Background: Large numbers of vulnerable patients are in need of palliative cancer and dementia care. However, a wide gap exists between the knowledge of best practices in palliative care and their use in everyday clinical practice. As part of a European policy improvement program, quality indicators (QIs) have been developed to monitor and improve the organisation of palliative care for patients with cancer and those with dementia in various settings in different European countries.

Method: A multidisciplinary, international panel of professionals participated in a modified RAND Delphi procedure to compose a set of palliative care QIs based on existing sets of QIs on the organisation of palliative care. Panellists participated in three written rounds, one feedback round and one meeting. The panel's median votes were used to identify the final set of QIs.

Results: The Delphi procedure resulted in 23 useful QIs. These QIs represent key elements of the organisation of good clinical practice, such as the availability of palliative care teams, the availability of special facilities to provide palliative care for patients and their relatives, and the presence of educational interventions for professionals. The final set also includes QIs that are related to the process of palliative care, such as documentation of pain and other symptoms, communication with patients in need of palliative care and their relatives, and end-of-life decisions.

Conclusion: International experts selected a set of 23 QIs for the organisation of palliative care. Although we particularly focused on the organisation of cancer and dementia palliative care, most QIs are generic and are applicable for other types of diseases as well.

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Figures

Figure 1
Figure 1
Modified RAND Delphi procedure. 1Equivocal is defined as all QIs on which there was no agreement: e.g. QIs with 30% or more of ratings in both the 1–3 tertile and the 7–9 tertile and all indicators with a median rating in the 4–6 tertile. 2At the end of round three, panelists agreed that 11 QIs could be merged.
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Pre-publication history
    1. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1472-6963/14/396/prepub

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