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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

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Published on: September 30, 2020

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

Charlèss Dupont^1,2, Robrecht De Schreye¹, Joachim Cohen^1,2

¹VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussel, Belgium.

International Journal of Environmental Research and Public Health

|January 22, 2021

Summary

High-quality end-of-life care in nursing homes requires effective palliative care. This study developed and validated 19 quality indicators for monitoring palliative care access and outcomes in nursing homes.

Keywords:

end of life care nursing homes palliative care quality indicators quality measurement quality of care

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Area of Science:

Gerontology
Palliative Care
Health Services Research

Background:

Nursing home residents represent a growing, frail population requiring high-quality end-of-life care.
Access to and implementation of palliative care in nursing homes are critical but often challenging.
Quality indicators are essential for monitoring and improving palliative care services.

Purpose of the Study:

To develop and validate a set of quality indicators for palliative care in nursing homes.
To establish a tailored measurement procedure for these indicators.
To assess the usability and effectiveness of the indicators for quality monitoring.

Main Methods:

A mixed-methods design was employed, involving three phases: literature search, expert interviews, and indicator selection via RAND/UCLA expert consensus.
The developed instrument was pilot tested and evaluated in nine nursing homes in Flanders, Belgium.
Both quantitative and qualitative analyses were conducted to assess indicator properties and caregiver feedback.

Main Results:

A set of 19 quality indicators for palliative care in nursing homes was selected from an initial 26.
Key themes identified include advance care planning, resident autonomy, and family communication.
The indicators demonstrated preliminary face validity, discriminative power, and were deemed useful for quality monitoring by caregivers.

Conclusions:

The developed quality indicators provide a measurable framework for assessing palliative care in nursing homes.
These indicators can facilitate continuous monitoring of palliative care access for all nursing home residents.
Further implementation studies are recommended to evaluate the process and impact of these quality indicators.