Outcome indicators in palliative care--how to assess quality and success. Focus group and nominal group technique in Germany.
OBJECTIVE
The call for clinically relevant outcome criteria has been raised, as assessment of adequate quality of service providers is essential with increasing momentum in the development of palliative care in most European countries. The aim of this study is to investigate important dimensions and indicators for assessment and evaluation of palliative care from the perspective of multi-disciplinary German experts working over years in the field of palliative care.


METHODS
A focus group, using the structured consensus method of the improved nominal group technique (INGT), with nine experts from different disciplines was conducted in Germany.


RESULTS
An abundance of topics (16) were identified, pointing at the complexity of the issue. Main topics were: quality of life, needs assessments of patients and relatives, resource assessment, surveillance of decision-making processes, as well as spiritual well-being. The following properties were claimed as essential for outcome criteria sensitivity, without additional burden on patients, easy applicability, scientific validity, and helpful for communication within the team, ethical discussions as well as for quality management.


CONCLUSIONS
The study identified topics considered important by experts in clinical practise. The discussions exposed the diversity of demands on outcome assessment put up by different stakeholder groups. This and the high number of relevant items show the complexity for the agreement on a unique set of outcome criteria. Further research considering other perspectives is needed.
Pastrana
Tania
T
Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany. tpastrana@ukaachen.de
Radbruch
Lukas
L
Nauck
Friedemann
F
Höver
Gerhard
G
Fegg
Martin
M
Pestinger
Martina
M
Ross
Josef
J
Krumm
Norbert
N
Ostgathe
Christoph
C
D032921:Consensus; D017144:Focus Groups; D005858:Germany; D006801:Humans; D020380:Needs Assessment / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010166:Palliative Care / Q000458:organization & administration* / Q000523:psychology; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D029181:Spirituality
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