PLoS ONE (Jan 2022)

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

  • Dawn M Guthrie,
  • Nicole Williams,
  • Cheryl Beach,
  • Emma Buzath,
  • Joachim Cohen,
  • Anja Declercq,
  • Kathryn Fisher,
  • Brant E Fries,
  • Donna Goodridge,
  • Kirsten Hermans,
  • John P Hirdes,
  • Hsien Seow,
  • Maria Silveira,
  • Aynharan Sinnarajah,
  • Susan Stevens,
  • Peter Tanuseputro,
  • Deanne Taylor,
  • Christina Vadeboncoeur,
  • Tracy Lyn Wityk Martin

DOI
https://doi.org/10.1371/journal.pone.0266569
Journal volume & issue
Vol. 17, no. 4
p. e0266569

Abstract

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BackgroundIndividuals 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.MethodsThe 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.ResultsBased 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.ConclusionsThrough 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.