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Measuring the quality of hospice and palliative care: benefits and pitfalls for providers

Publication at Central Library of Charles University |
2022

Abstract

Introduction

Knowledge of the parameters of the quality of care is important for the provision of hospice care, but in the Czech Republic there is a lack of a tool that would be systematically used to measure the quality of care. The palliative care center, in cooperation with hospice care providers, has developed a methodology for the collection and analysis of standardized data, both from providers and users.

Aim

The aim of the study was to find out the benefits and barriers to the implementation and use of this methodology from the point of view of users, i.e. providers of hospice care.

Methodology

The implementation of the quality measurement was piloted for 12 months in 2 inpatient and 4 outpatient hospices. Qualitative data were collected using semi-structured in-depth interviews with the directors and/or staff of the participating hospices (n=10). Online meetings with providers that took place during implementation were also included in the thematic analysis. The SWOT analysis pointed to strengths and weaknesses as well as opportunities and threats when using the methodology.

Results

The following strengths were identified: user-friendliness, tolerable time requirements for ensuring data collection and final reports as a basis for the strategic planning or improving the quality of services. Weaknesses include the length of the questionnaire for the bereaved carers ; the poorer comprehensibility of some items or the frequency of filling in data. Regular meetings of hospice representatives (transfer of experience), changes in patient documentation (recording method or new records, e.g. ESAS) or a questionnaire as a way to establish communication with the bereaved were identified as opportunities for further development. The sustainability of the methodology, the low replaceability of involved employees or the loss of interest on the part of hospices can be considered as the main treaths.

Conclusion

The implementation of the methodology requires motivation and commitment on the part of hospices, however, it allows to better define some internal processes. In addition, the obtained outputs provide a wide range of possibilities of use: from the promotion of the concrete hospice care to the advocacy of hospice care in general.