title: International Association for Hospice and Palliative Care (IAHPC) List of Essential Practices in Palliative Care.
abstract: The objective of this study was to identify, through a consensus process, the essential practices in primary palliative care. A three-phase study was designed. Phase 1 methods included development of a working group; a literature review; development of a baseline list of practices; and identification of levels of intervention. In Phase 2, physicians, nurses, and nurse aides (n = 425) from 63 countries were asked in three Delphi rounds to rate the baseline practices as essential or nonessential and select the appropriate levels of intervention for each. In Phase 3, representatives of 45 palliative care organizations were asked to select and rank the 10 most important practices resulting from Phase 2. Scores (1-10) were assigned to each, based on the selected level of importance. Results of Phase 1 were a baseline list of 140 practices. Three levels of intervention were identified: Identification/Evaluation; Diagnosis; and Treatment/Solution measures. In Phase 2, the response rates (RR) for the Delphi rounds were 96.5%, 73.6%, and 71.8%, respectively. A consensus point (≥80% agreement) was applied, resulting in 62 practices. In Phase 3, RR was 100%. Forty-nine practices were selected and ranked. "Evaluation, Diagnosis and Treatment of Pain" scored the highest (352 points). The working group (WG) arranged the resulting practices in four categories: Physical care needs, Psychological/Emotional/Spiritual care needs, Care Planning and Coordination, and Communication. The IAHPC List of Essential Practices in Palliative care may help define appropriate primary palliative care and improve the quality of care delivered globally. Further studies are needed to evaluate their uptake and impact.
authors: International Association for Hospice and Palliative Care (IAHPC), Houston, Texas 77007, USA. ldelima@iahpc.com
authors: Liliana
authors: L
authors: De Lima
authors: Michael I
authors: MI
authors: Bennett
authors: Scott A
authors: SA
authors: Murray
authors: Peter
authors: P
authors: Hudson
authors: Derek
authors: D
authors: Doyle
authors: Eduardo
authors: E
authors: Bruera
authors: Clara
authors: C
authors: Granda-Cameron
authors: Florian
authors: F
authors: Strasser
authors: Julia
authors: J
authors: Downing
authors: Roberto
authors: R
authors: Wenk
mesh_terms: D032921:Consensus; D003697:Delphi Technique; D006801:Humans; D007390:International Agencies; D009726:Nurses / Q000458:organization & administration; D009728:Nursing Assistants / Q000458:organization & administration; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D010820:Physicians / Q000458:organization & administration; D057184:Practice Patterns, Nurses' / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D011787:Quality of Health Care