Development of a set of process and structure indicators for palliative care: the Europall project

Abstract

BackgroundBy measuring the quality of the organisation of palliative care with process and structure quality indicators (QIs), patients, caregivers and policy makers are able to monitor to what extent recommendations are met, like those of the council of the WHO on palliative care and guidelines. This will support the implementation of public programmes, and will enable comparisons between organisations or countries.MethodsAs no European set of indicators for the organisation of palliative care existed, such a set of QIs was developed. An update of a previous systematic review was made and extended with more databases and grey literature. In two project meetings with practitioners and experts in palliative care the development process of a QI set was finalised and the QIs were categorized in a framework, covering the recommendations of the Council of Europe.ResultsThe searches resulted in 151 structure and process indicators, which were discussed in steering group meetings. Of those QIs, 110 were eligible for the final framework.ConclusionsWe developed the first set of QIs for the organisation of palliative care. This article is the first step in a multi step project to identify, validate and pilot QIs.

Place of care: from referral to specialist palliative care until death

“…Ease of transfer between care settings and place of care may be more reflective of the quality of care we provide. A European collaborative working group proposed a set of quality indicators (QI), called ‘The Europall Project’, relating to the palliative care organisational process and structure 25. Access to and availability of palliative care across all care domains was identified as a key QI.…”

MASCC/ESMO/EAPC survey of palliative programs

“…All team members should be accredited and a psychosocial assessment along with symptom assessment should occur within 24 h of admission to a palliative care unit. Palliative care programs should have quality assurance, research and fellowship programs [14]. In this regard, many programs fall short in one or more areas.…”

“…Although there are no universally embraced quality indicators for the organization of palliative care, a number of quality indicators were generated from a Europall project systematic review [14]. These quality indicators include 24/7 availability of the consultative team, a staff that includes a pharmacist, and a single caregiver that can coordinate care to provide continuity across service lines.…”

Validation of quality indicators for the organization of palliative care: A modified RAND Delphi study in seven European countries (the Europall project)

“…10 This method is used to determine the extent of agreement on an issue and is a validated method for developing QIs. It allows the consultation of a large number of geographically dispersed experts in a short period of time.…”