Quality Indicators for Palliative Care: Update of a Systematic Review

Roo, Maaike L. De; Leemans, Kathleen; Claessen, Susanne; Cohen, Joachim; Pasman, H. Roeline W.; Deliens, Luc; Francké, Anneke L.

doi:10.1016/j.jpainsymman.2012.09.013

Cited by 172 publications

(181 citation statements)

References 48 publications

Supporting

Mentioning

167

Contrasting

Unclassified

Order By: Relevance

“…Unfortunately, very few health care organizations measure the quality of EOL care in general, and specifically, aspects of EOL communication and decision making. 11 Although much has been done to develop quality indicators in the broad field of palliative/EOL care, 12 we are unaware of any other quality indicators specifically related to EOL communication and decision making.…”

Section: Introductionmentioning

confidence: 99%

Improving End-of-Life Communication and Decision Making: The Development of a Conceptual Framework and Quality Indicators

Sinuff

Dodek

You

et al. 2015

Journal of Pain and Symptom Management

194

193

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Improving End-of-Life Communication and Decision Making: The Development of a Conceptual Framework and Quality Indicators

Sinuff

Dodek

You

et al. 2015

Journal of Pain and Symptom Management

194

193

View full text Add to dashboard Cite

show abstract

“…One of these is recognising when aggressive or curative treatment or hospitalisation is no longer beneficial, [11][12][13] because hospitalisations may complicate care provision and result in a lower quality of death.…”

Section: Introductionmentioning

confidence: 99%

Comparison of end-of-life care for older people living at home and in residential homes: a mortality follow-back study among GPs in the Netherlands

et al. 2015

Self Cite

View full text Add to dashboard Cite

BackgroundThe proportion of older people is increasing, therefore their place of residence and place of care at the end of life are becoming increasingly important. AimTo compare aspects of end-of-life care among older people in residential homes and home settings in the Netherlands. Design and settingNationwide representative mortality followback study among GPs in the Netherlands. MethodThe study included patients aged ≥65 years who died non-suddenly, whose longest place of residence in their last year of life was at home or in a residential home (n = 498). Differences were analysed using Pearson's χ 2 test, MannWhitney U tests, and multivariate logistic regression. ResultsControlling for the differences between the populations in home settings and residential homes, no differences were found in treatment goals, communication about end-of-life care, or use of specialised palliative care between the two settings. However, people living in a residential home were more likely to have received palliative care from a GP than people living at home (OR 2.84, 95% confidence interval [CI] = 1.41 to 5.07). In residential homes, people more often experienced no transfer between care settings (OR 2.76, 95% CI = 1.35 to 5.63) and no hospitalisations (OR 2.2, 95% CI = 1.04 to 4.67) in the last 3 months of life, and died in hospital less often (OR 0.78, 95% CI = 0.63 to 0.97) than those people living at home. ConclusionDespite similar treatment goals, care in residential homes seems more successful in avoiding transfers and hospitalisation at the end of life. Especially since older people are encouraged to stay at home longer, measures should be taken to ensure they are not at higher risk of transfers and hospitalisations in this setting. Keywordsend of life care; general practitioner; palliative care; residential facilities; terminal care.

show abstract

“…8 Recently, some quality indicators were developed in the broad field of palliative/end-of-life care. 17,19,20 Some of these include aspects of communication and decision-making, but these domains are not the focus of these measures. Accordingly, we developed 9 and have now validated a novel set of quality indicators that are specifically related to end-of-life communication and decision-making.…”

Section: Discussionmentioning

confidence: 99%

Validation of quality indicators for end-of-life communication: results of a multicentre survey

Heyland

Dodek

You

et al. 2017

CMAJ

View full text Add to dashboard Cite

Despite numerous calls to improve end-of-life care, and communication and decision-making in particular, [1][2][3][4] over 2 decades there has been little progress in this arena. 5,6 One of the major reasons for this limited progress may be the lack of quality indicators that are meaningful at a health system level to guide decision-makers as they introduce policies and practices to improve end-of-life care. 7,8 We recently published a study that used a modified Delphi consensus process to develop a set of quality indicators related to advance care planning, goals-of-care discussions and documentation of these plans and goals (Table 1).9 Quality indicators should be evaluated based on their reliability, validity, responsiveness to change and ease of implementation.10 Because of the robust methodology used in developing these quality indicators, 9 we believe they are clinically sensible and have face and content validity. Here we describe implementation of these quality indicators in a multicentre study to evaluate their feasibility and construct validity. A secondary objective was to establish a method for ranking institutions with respect to their performance in end-of-liferelated communication and decision-making. MethodsThis work was guided by a conceptual model of communication and decision-making in seriously ill and older patients who had been admitted to hospital, and the impact of these processes on patient-centred outcomes (Figure 1). 9 To validate the aforementioned quality indicators, we conducted a multicentre, prospective audit of communication and decision-making related to the use or nonuse of life-sustaining treatments during serious illness, from the perspectives of patients and their family members; this was called the Audit of Communication, Care Planning, and The lack of validated quality indicators is a major barrier to improving end-of-life communication and decision-making. We sought to show the feasibility of and provide initial validation for a set of quality indicators related to end-of-life communication and decision-making.

show abstract

Quality Indicators for Palliative Care: Update of a Systematic Review

Cited by 172 publications

References 48 publications

Improving End-of-Life Communication and Decision Making: The Development of a Conceptual Framework and Quality Indicators

Improving End-of-Life Communication and Decision Making: The Development of a Conceptual Framework and Quality Indicators

Comparison of end-of-life care for older people living at home and in residential homes: a mortality follow-back study among GPs in the Netherlands

Validation of quality indicators for end-of-life communication: results of a multicentre survey

Contact Info

Product

Resources

About