. 2022 Apr 7;17(4):e0266569.

doi: 10.1371/journal.pone.0266569. eCollection 2022.

A multi-stage process to develop quality indicators for community-based palliative care using interRAI data

Dawn M Guthrie^{1

2}, Nicole Williams¹, Cheryl Beach³, Emma Buzath⁴, Joachim Cohen⁵, Anja Declercq^{6

7}, Kathryn Fisher⁸, Brant E Fries⁹, Donna Goodridge¹⁰, Kirsten Hermans⁶, John P Hirdes¹¹, Hsien Seow¹², Maria Silveira¹³, Aynharan Sinnarajah¹⁴, Susan Stevens¹⁵, Peter Tanuseputro¹⁶, Deanne Taylor^{17

18}, Christina Vadeboncoeur^{19

20

21}, Tracy Lyn Wityk Martin⁴

Affiliations

¹ Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada.
² Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada.
³ Integrated Community Services, Fraser Health, Surrey, British Columbia, Canada.
⁴ Provincial Palliative and-End-of-Life Care, Seniors Health and Continuing Care, Alberta Health Services, Calgary, Alberta, Canada.
⁵ End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
⁶ LUCAS - Center for Care Research and Consultancy, KU Leuven, Leuven, Belgium.
⁷ CESO - Center for Sociological Research, KU Leuven, Leuven, Belgium.
⁸ School of Nursing, McMaster University, Hamilton, Ontario, Canada.
⁹ Department of Health Management and Policy and Department of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
¹⁰ College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹¹ School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
¹² Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
¹³ Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
¹⁴ Department of Medicine, Queen's University, Kingston, Ontario, Canada.
¹⁵ Nova Scotia Health, Halifax, Halifax, Nova Scotia, Canada.
¹⁶ Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁷ Research Department, Interior Health Authority, Kelowna, British Columbia, Canada.
¹⁸ Rural Coordination Centre of BC, Penticton, British Columbia, Canada.
¹⁹ Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
²⁰ Children's Hospital of Eastern Ontario Ottawa, Ontario, Canada.
²¹ Roger Neilson House, Ottawa, Ontario, Canada.

PMID: 35390091
PMCID: PMC8989210
DOI: 10.1371/journal.pone.0266569

A multi-stage process to develop quality indicators for community-based palliative care using interRAI data

Dawn M Guthrie et al. PLoS One. 2022.

. 2022 Apr 7;17(4):e0266569.

doi: 10.1371/journal.pone.0266569. eCollection 2022.

Authors

Affiliations

¹ Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada.
² Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada.
³ Integrated Community Services, Fraser Health, Surrey, British Columbia, Canada.
⁴ Provincial Palliative and-End-of-Life Care, Seniors Health and Continuing Care, Alberta Health Services, Calgary, Alberta, Canada.
⁵ End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
⁶ LUCAS - Center for Care Research and Consultancy, KU Leuven, Leuven, Belgium.
⁷ CESO - Center for Sociological Research, KU Leuven, Leuven, Belgium.
⁸ School of Nursing, McMaster University, Hamilton, Ontario, Canada.
⁹ Department of Health Management and Policy and Department of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
¹⁰ College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹¹ School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
¹² Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
¹³ Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
¹⁴ Department of Medicine, Queen's University, Kingston, Ontario, Canada.
¹⁵ Nova Scotia Health, Halifax, Halifax, Nova Scotia, Canada.
¹⁶ Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁷ Research Department, Interior Health Authority, Kelowna, British Columbia, Canada.
¹⁸ Rural Coordination Centre of BC, Penticton, British Columbia, Canada.
¹⁹ Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
²⁰ Children's Hospital of Eastern Ontario Ottawa, Ontario, Canada.
²¹ Roger Neilson House, Ottawa, Ontario, Canada.

PMID: 35390091
PMCID: PMC8989210
DOI: 10.1371/journal.pone.0266569

Erratum in

Correction: A multi-stage process to develop quality indicators for community-based palliative care using interRAI data.
Guthrie DM, Williams N, Beach C, Buzath E, Cohen J, Declercq A, Fisher K, Fries BE, Goodridge D, Hermans K, Hirdes JP, Seow H, Silveira M, Sinnarajah A, Stevens S, Tanuseputro P, Taylor D, Vadeboncoeur C, Wityk Martin TL. Guthrie DM, et al. PLoS One. 2024 Dec 19;19(12):e0316372. doi: 10.1371/journal.pone.0316372. eCollection 2024. PLoS One. 2024. PMID: 39700103 Free PMC article.

Abstract

Background: Individuals receiving palliative care (PC) are generally thought to prefer to receive care and die in their homes, yet little research has assessed the quality of home- and community-based PC. This project developed a set of valid and reliable quality indicators (QIs) that can be generated using data that are already gathered with interRAI assessments-an internationally validated set of tools commonly used in North America for home care clients. The QIs can serve as decision-support measures to assist providers and decision makers in delivering optimal care to individuals and their families.

Methods: The development efforts took part in multiple stages, between 2017-2021, including a workshop with clinicians and decision-makers working in PC, qualitative interviews with individuals receiving PC, families and decision makers and a modified Delphi panel, based on the RAND/ULCA appropriateness method.

Results: Based on the workshop results, and qualitative interviews, a set of 27 candidate QIs were defined. They capture issues such as caregiver burden, pain, breathlessness, falls, constipation, nausea/vomiting and loneliness. These QIs were further evaluated by clinicians/decision makers working in PC, through the modified Delphi panel, and five were removed from further consideration, resulting in 22 QIs.

Conclusions: Through in-depth and multiple-stakeholder consultations we developed a set of QIs generated with data already collected with interRAI assessments. These indicators provide a feasible basis for quality benchmarking and improvement systems for care providers aiming to optimize PC to individuals and their families.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr. A. Sinnarajah has received research grants (last 5 years) on palliative care (as principal investigator or co-investigator), from the Canadian Institutes of Health Research, MSI Foundation, Canadian Cancer Society, Applied Research in Cancer Control, College of Family Physicians of Canada, Choosing Wisely Alberta, Alberta Innovates Health Research, Alberta Cancer Foundation, Alberta Health Services, University of Calgary, Canadian Frailty Network, Alberta Health and Campus Alberta Health Outcomes and Public Health. He has an academic appointment for palliative care research with Queen’s University and Lakeridge Health (currently), and University of Calgary (last 5 years). Lastly, he is/has paid medical administrative positions with Alberta Health Services and Lakeridge Health. The remaining authors declare that no competing interests exist. We confirm that Dr. Sinnarajah has some competing interests to report (previously detailed in the online submission) and we confirm that this does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

**Fig 1. Summary of the steps in the QI development process.**

See this image and copyright information in PMC

References

1. Meier DE. Increased access to palliative care and hospice services: opportunities to improve value in health care. The Milbank Quarterly. 2011;89(3):343–80. doi: 10.1111/j.1468-0009.2011.00632.x - DOI - PMC - PubMed
1. Alberta Health Services. Palliative and End-of-life Care: Alberta Provincial Framework. Calgary, AB: 2014.
1. Roulston E. Canadians’ View of Palliative Care: National Online Survey. Toronto, ON: Canadian Partnership Against Cancer/Ipsos Public Affairs, 2016.
1. Health Quality Ontario. Palliative care at the end of life. Toronto: Health Quality Ontario, 2016.
1. Gagnon B, Nadeau L, Scott S, Dumont S, MacDonald N, Aubin M, et al.. The association between home palliative care services and quality of end-of-life care indicators in the province of Quebec. Journal of Pain and Symptom Management. 2015;50(1):48–58. doi: 10.1016/j.jpainsymman.2014.12.012 . - DOI - PubMed

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A multi-stage process to develop quality indicators for community-based palliative care using interRAI data

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A multi-stage process to develop quality indicators for community-based palliative care using interRAI data

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

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References

Publication types

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Grants and funding

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