Implementation Strategies for Quality Improvement in Palliative Care: A Scoping Review.

Area of Science:

• Palliative Care
• Quality Improvement
• Implementation Science

Background:

• Quality improvement (QI) programs are crucial for optimal palliative care.
• Routine implementation of person-centred outcome measures (PCOMs) in QI programs faces challenges.

Purpose of the Study:

• Identify implementation strategies for routine PCOM use in hospital palliative care.
• Identify implementation theories, models, and frameworks (TMFs) guiding these strategies.

Main Methods:

• Conducted a scoping review following the Joanna Briggs Institute (JBI) framework.
• Systematically searched four databases (Medline, CINAHL, Scopus, PubMed) for literature from 1990 to March 2024.

Main Results:

• 115 implementation strategies mapped to 52% of Expert Recommendations for Implementing Change (ERIC) strategies.
• Common strategies included stakeholder training, clinician support, and stakeholder relationship development.
• Three key themes emerged: what to do, how to do it, and who to do it with; only four studies used TMFs.

Conclusions:

• Develop PCOM implementation strategies using identified barriers/facilitators and rigorous TMFs.
• Transparent and consistent reporting of strategy components is essential for replication and measurement.