What outcome domains are considered core to assessing the impact of adult specialist palliative care services in Wales? A rapid review

Abstract

Assessment of palliative care delivery is essential for managing service performance and providing im-provement in care (Donabedian, 2005). However, such assessments have tended to focus on capturing process related outcomes (service volume, response times etc.) to demonstrate service activity, rather than consistently measuring impact of services on patient and family. There has been increasing emphasis on, and international consensus on the need for, outcomes which focus more specifically on impact, in particular on domains such as quality, effectiveness and efficiency of palliative care rather than just service activity (Davis et al., 2013, Clark et al., 2016). Recently, there have been several initiatives to standardise approaches to this type of outcome assess-ment and to encourage regional approaches which will meet local needs but also allow benchmarking at national and international levels. In Wales, the End-of-Life Board (EoLB) has prioritised the need to establish a standardised approach to the collection of this type of data set, by establishing a consensus on the domains of importance and to identify whether an existing approach such as the Outcome Assessment and Complexity Collaborative (OACC) (Witt et al., 2014) or Palliative Care Outcomes Collaboration (PCOC) (Eager et al., 2010), may meet ‘needs’ in Wales or whether the specific health and social care economy unique to Wales man-dates for additional or different domains of care to be addressed. This project is a multi-stage study, with this first stage rapid review identifying from the published literature those outcomes for adult palliative care services that are considered most important to capture in order to assess service quality

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