CN21 - Development of core indicators of non-specialist palliative care in hospitals: An international modified Delphi study

Abstract

BackgroundHealthcare providers working in acute care hospitals have significant exposure to cancer patients with palliative care needs, and for the majority of patients these reflect non-specialist rather than specialist palliative care needs. Embedding non-specialist palliative care in acute hospital-based care is challenging. The aim of this paper is to present a core set of indicators for the provision of non-specialist palliative care in hospitals which was determined using a Delphi consensus process. MethodsPreliminary indicators derived from a concept analysis and systematic review were subjected to a three round modified Delphi study, whereby a multidisciplinary expert panel of key stakeholders appraised (rated) each preliminary indicator on its ‘importance’ to non-specialist palliative care provision in hospitals. Stakeholders were also offered an opportunity to add ‘new’ indicators as they considered relevant. Consensus was defined whereby 70%, or more, of the participants across stakeholder groups agreed that an indicator was ‘core’ to non-specialist palliative care provision in the hospital setting. ResultsA total of 92 experts (74% response rate) representing the views of patients, clinicians and researchers, from twelve countries participated in the final round. This study resulted in 32 core indicators of hospital based non-specialist palliative care, categorised into 5 structural indicators (relating to infrastructure and governance), 21 organisational indicators (relating to clinical care processes) and 6 staff indicators (relating to training and support for healthcare providers). ConclusionsThis study presents the first guidance for clinical practice, policy and research related to non-specialist palliative care provision in hospitals, based on evidence and International consensus from all key stakeholder groups. These indicators provide a means to assess, review, and communicate the core elements of non-specialist palliative care in hospitals, thereby setting a benchmark for changes in policy and practice. Legal entity responsible for the studyThe authors. FundingHealth Research Board. DisclosureAll authors have declared no conflicts of interest.