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Care Consistency With Documented Care Preferences: Methodologic Considerations for Implementing the "Measuring What
Kathleen T Unroe1, Susan E Hickman2, Alexia M Torke3
1Indiana University Center for Aging Research, Indianapolis, Indiana, USA; Regenstrief Institute, Inc., Indianapolis, Indiana, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; RESPECT Signature Center, Indiana University Purdue University, Indianapolis, Indiana, USA.
Journal of Pain and Symptom Management
|September 29, 2016
Summary
Ensuring patient preferences are followed in palliative care is crucial. This study addresses challenges in measuring "Care Consistency With Documented Care Preferences" and offers recommendations for accurate quality assessment.
Area of Science:
- Palliative Care
- Health Services Research
- Quality Measurement
Background:
- A core principle of palliative care involves understanding and respecting patient treatment preferences.
- The "Measuring What Matters quality" indicators include "Care Consistency With Documented Care Preferences" to assess healthcare quality.
- Practical application of this quality indicator in clinical settings presents logistical challenges.
Purpose of the Study:
- To describe methods for measuring care consistency with documented preferences in end-of-life research.
- To identify and outline methodological challenges in applying this quality indicator in research and practice.
- To provide recommendations for improving the measurement of care consistency with documented preferences.
Main Methods:
- Review of existing research methodologies for measuring care consistency with documented preferences in end-of-life care.
- Analysis of practical and logistical issues encountered in applying the "Care Consistency With Documented Care Preferences" indicator.
- Development of recommendations based on identified measurement challenges.
Main Results:
- Existing methods for measuring care consistency with documented preferences have limitations.
- Key challenges include issues with documentation, preference specificity and relevance, preference stability over time, and measuring instances where a preference was not acted upon (nonevents).
Conclusions:
- Accurate measurement of "Care Consistency With Documented Care Preferences" is essential for quality palliative care.
- Recommendations include standardizing preference documentation, selecting appropriate preferences for tracking, establishing review protocols, and adopting consistent measurement approaches.
- Addressing these methodological challenges will enhance the reliability and validity of this quality marker.
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