title: Quality improvement in palliative care services and networks: preliminary results of a benchmarking process in Catalonia, Spain.
abstract: BACKGROUND
  A wide range of palliative care services has been implemented in Catalonia over the past 20 years. Quantitative and qualitative differences in the organization of palliative care services between districts and settings can result in wide variability in the quality of these services, and their accessibility.
  
  
  METHODS
  We implemented a benchmark methodology to compare dimensions of care and organization, to identify aspects requiring improvement, and to establish indicators to measure progress. The overall aim was to generate a consensus document for submission to the Department of Health (DoH) of the Government of Catalonia.
  
  
  RESULTS
  A Steering Committee convoked a meeting in Barcelona (Catalonia, Spain) and representatives (n = 114) of all the 37 districts within our health care remit (rural, urban, intermediate, and metropolitan) and settings of the health care system (hospitals, social health centers, community, and nursing homes) attended and took part in plenary sessions and workshops to define areas that, in their experience, were considered weak. Twenty-one consensus recommendations achieving high levels of consensus were generated for submission to the DoH. These included the formal definition of the model of care and organization of palliative care services at all levels in the region, the implementation of measures for improvement in different settings and scenarios, systems for continuous care, and facilities for the continuing training of health care personnel. These proposals have since been implemented in a trial region and, depending on the outcomes, will be applied throughout our health service.
  
  
  CONCLUSIONS
  We conclude that benchmark methodology is valuable in acquiring data for use in improving palliative care organization for patients' benefit.
authors.affiliation: WHO Collaborating Center for Palliative Care Public Health Programs, Catalan Institute of Oncology, Department of Health, Barcelona, Spain. Xgomez.WHOCC@iconcologia.net
authors.forename: Xavier
authors.initials: X
authors.lastname: Gómez-Batiste
authors.forename: Carmen
authors.initials: C
authors.lastname: Caja
authors.forename: Jose
authors.initials: J
authors.lastname: Espinosa
authors.forename: Ingrid
authors.initials: I
authors.lastname: Bullich
authors.forename: Josep
authors.initials: J
authors.lastname: Porta-Sales
authors.forename: Carme
authors.initials: C
authors.lastname: Sala
authors.forename: Esther
authors.initials: E
authors.lastname: Limón
authors.forename: Jordi
authors.initials: J
authors.lastname: Trelis
authors.forename: Antonio
authors.initials: A
authors.lastname: Pascual
authors.forename: M
authors.initials: M
authors.lastname: Luisa Puente
mesh_terms: D019985:Benchmarking / Q000379:methods*; D006801:Humans; D010166:Palliative Care / Q000592:standards*; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D013030:Spain