Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

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

Version 1 : Received: 16 December 2020 / Approved: 17 December 2020 / Online: 17 December 2020 (11:07:43 CET)

A peer-reviewed article of this Preprint also exists.

Dupont, C.; De Schreye, R.; Cohen, J.; De Ridder, M.; Van den Block, L.; Deliens, L.; Leemans, K. Pilot Study to Develop and Test Palliative Care Quality Indicators for Nursing Homes. Int. J. Environ. Res. Public Health 2021, 18, 829. Dupont, C.; De Schreye, R.; Cohen, J.; De Ridder, M.; Van den Block, L.; Deliens, L.; Leemans, K. Pilot Study to Develop and Test Palliative Care Quality Indicators for Nursing Homes. Int. J. Environ. Res. Public Health 2021, 18, 829.

Journal reference: Int. J. Environ. Res. Public Health 2021, 18, 829
DOI: 10.3390/ijerph18020829

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 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 the indicators were measurable, had good preliminary face validity and discriminative power and were considered 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 residents in nursing homes.

Keywords

nursing homes; quality indicators; quality measurement; palliative care; quality of care; end of life care; advance care planning

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