What should be measured to assess the quality of community-based palliative care? Results from a collaborative expert workshop

Abstract

Objectives The need for palliative care (PC) will continue to increase in Canada with population aging. Many older adults prefer to “age in place” and receive care in their own homes. Currently, there is a lack of standardized quality indicators (QIs) for PC delivered in the community in Canada. Methods A one-day workshop collected expert opinions on what should be measured to capture quality PC. Three brainstorming sessions were focused on addressing the following questions: (1) what is important to measure to support quality PC, regardless of setting? (2) Of the identified measures, are any of special importance to care provided in the home? (3) What are the challenges, barriers, and opportunities for creating these measures? The National Consensus Project (NCP) for Quality Palliative Care framework was used as a guide to group together important comments into key themes. Results The experts identified four themes that are important for measuring quality, regardless of care setting, including access to care in the community by a multidisciplinary team, care for the individual with PC needs, support for the informal caregiver (e.g., family, friends), and symptom management for individuals with PC needs. Two additional themes were of special importance to measuring quality PC in the home, including spiritual care for individuals with PC needs and home as the preferred place of death. The challenges, barriers, and potential opportunities to these quality issues were also discussed. Significance of results PC experts, through this collaborative process, made a substantial contribution to the creation of a standardized set of QIs for community-based PC. Having a standardized set of QIs will enable health care professionals and decision makers to target areas for improvement, implement interventions to improve the quality of care, and ultimately, optimize the health and well-being of individuals with a serious illness.

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

“…The first activity, in this phase, involved input from decision makers from across Ontario, Canada’s largest province. A group of 30 PC experts participated in a one-day workshop, the results of which have been published previously [ 44 ]. Participants included clinical leaders, researchers, front-line care providers as well as health and information system administrators.…”

POMSNAME: an aide-mémoire to improve the assessment and documentation of palliative care – a longitudinal project

“…Assessment and documentation skills are pivotal to quality palliative care – this extends to community-based palliative care [ 44 ]. As demonstrated in this article, the aide-mémoire – POMSNAME – represents an effective way to improve clinician assessment and documentation of important palliative care domains.…”

“…and how. Given the important roles of assessment and documentation in quality palliative care [ 44 ], this modest project represents a worthwhile contribution to the evidence on how to improve palliative care, particularly that which is community-based.…”

A Graduated Approach to Spiritual Intervention in Health and Long-Term Care

“…This is the first step in any spirituality-based practice-finding language that is comfortable, authentic, and credible. Asking about spirituality has been repeatedly confirmed to be a key element of quality care (Williams et al 2022).…”