Organizational standards for specialist palliative care for adult patients: Recommendations of the Expert Group of National Consultants in Palliative Medicine and Palliative Care Nursing

Introduction: The study aimed to develop organizational standards for specialist palliative care for adult patients (OSSPCAP) in Poland. Methods: The National Consultants in Palliative Medicine and Palliative Care Nursing appointed an Expert Group consisting of three physicians — independent researchers, two nurses and a lawyer to develop the OSSPCAP. The work was done in three stages. 1. Literature analysis (Scopus and PubMed databases) and legislation on palliative care. 2. Questionnaire development using Google Forms and survey of 120 respondents in two rounds using the Delphi method. 3. Analysis of the results by the Expert Group during remote meetings and determination of the final version of the OSSPCAP. Results: The response rate in the first round of the survey was 71 (59.17%) and in the second 58 (48.33%). The first round yielded 73 positive responses (at least 70% criterion) to 97 questions; the second round yielded 21 positive responses to 31 questions. For the remaining ten questions, the Expert Group members discussed the results obtained with at least 50% criterion of positive responses. The results of both rounds were analyzed, and the final version of the document was accepted by all members of the Expert Group. Conclusions: Palliative care was divided into two types (levels): palliative care elements (palliative care approach) and specialist palliative care. In the latter home, inpatient and outpatient care was distinguished with ensuring public funding for all their organizational units by the State, including the integration into the guaranteed benefits. Requirements and procedures for all organizational units of specialist palliative care were depicted. Three specialist inpatient palliative care referral levels were offered taking into account complexity of services for patients, under- and postgraduate education. Principles of qualifying patients for palliative care, the development of research and education in palliative medicine and palliative care nursing were presented.Introduction: The study aimed to develop organizational standards for specialist palliative care for adultpatients (OSSPCAP) in Poland.Methods: The National Consultants in Palliative Medicine and Palliative Care Nursing appointed an ExpertGroup consisting of three physicians — independent researchers, two nurses and a lawyer to developthe OSSPCAP. The work was done in three stages. 1. Literature analysis (Scopus and PubMed databases)and legislation on palliative care. 2. Questionnaire development using Google Forms and survey of120 respondents in two rounds using the Delphi method. 3. Analysis of the results by the Expert Groupduring remote meetings and determination of the final version of the OSSPCAP.Results: The response rate in the first round of the survey was 71 (59.17%) and in the second 56 (46.67%).The first round yielded 73 positive responses (at least 70% criterion) to 97 questions; the second roundyielded 21 positive responses to 31 questions. For the remaining ten questions, the Expert Group membersdiscussed the results obtained with at least 50% criterion of positive responses. The results of both roundswere analyzed, and the final version of the document was accepted by all members of the Expert Group.Conclusions: Palliative care was divided into two types (levels): palliative care elements (palliative care approach)and specialist palliative care. In the latter home, inpatient and outpatient care was distinguishedwith ensuring public funding for all their organizational units by the State, including the integration into theguaranteed benefits. Requirements and procedures for all organizational units of specialist palliative care weredepicted. Three specialist inpatient palliative care referral levels were offered taking into account complexity ofservices for patients, under- and postgraduate education. Principles of qualifying patients for palliative care,the development of research and education in palliative medicine and palliative care nursing were presented