Pilot Study to Develop and Test Palliative Care Quality Indicators for Nursing Homes

Abstract

An increasingly frail population in nursing homes accentuates the need for high quality care at the end of life and better access to palliative care in this context. Implementation of palliative care and its outcomes can be monitored by using quality indicators. Therefore, we developed a quality indicator set for palliative care in nursing homes and a tailored measurement procedure while using a mixed-methods design. We developed the instrument in three phases: (1) literature search, (2) interviews with experts, and (3) indicator and measurement selection by expert consensus (RAND/UCLA). Second, we pilot tested and evaluated the instrument in nine nursing homes in Flanders, Belgium. After identifying 26 indicators in the literature and expert interviews, 19 of them were selected through expert consensus. Setting-specific themes were advance care planning, autonomy, and communication with family. The quantitative and qualitative analyses showed that the indicators were measurable, had good preliminary face validity and discriminative power, and were considered to be useful in terms of quality monitoring according to the caregivers. The quality indicators can be used in a large implementation study and process evaluation in order to achieve continuous monitoring of the access to palliative care for all of the residents in nursing homes.

Factors Affecting Application of Total Quality Management Activities at Oncology Center Mansoura University

“…The indicators and methods such as health facility surveys are highly transferable and could be used to measure quality of care in other countries. Similarly, Dupont et al, (2021) (22) reported that using both quantitative and qualitative analyses and instruments had good face validity, feasibility, discriminative power, and it is useful in terms of quality monitoring by caregivers. On the same line, Báo, Amestoy, Moura& Trindade, (2019) (23) stated that quality indicators are a tool for improving care, assisting nurses in knowing the patients whom care is provided to, helping the clinical decision-making regarding best practices in health care, assisting nurses in the work process through stimulating the critical thinking and favoring a better understanding of care, as well as promoting the prevention of future damages and mistakes in this practice.…”

Enhancing the Quality of Care in Long-Term Care Settings

“…This Special Issue also comprises intervention studies, with interventions aimed at addressing depressive symptoms in nursing home residents [10,11], adjustment for new residents [12], social and psychological support [13], and loneliness and isolation [14]. Other studies present evidence which developed and tested quality indicators [15,16], and tools which capture the experience of quality from a resident's perspective [17,18], and assess partnership working between staff and families [19]. We also included studies that investigated factors associated with older people's experiences, such as the association between length of stay and end of life care [20], dry eyes or ocular lubricants with medication use, dementia, frailty and dry eyes [21], resident characteristics and their palliative care service use and comfort in the last week of life [22] and causes of infection-related hospitalizations [23].…”