title: Methods for improving the quality of palliative care delivery: a systematic review.
abstract: BACKGROUND
  The effectiveness for improving the outcomes across palliative care domains remains unclear. We conducted a systematic review of different types of quality improvement interventions relevant to palliative care.
  
  
  METHODS
  We searched PubMed, CINAHL, PsycINFO, and Cochrane for relevant articles published between 2000 and 2011.
  
  
  RESULTS
  A total of 10 randomized controlled trials and 7 nonrandomized controlled trials were included. Of the 5 studies using relay of clinical information, 1 reported significant improvement in patient quality of life. Of the 5 studies targeting education and self-management, 4 found significant improvements in quality of life or patient symptoms.
  
  
  CONCLUSIONS
  A minority of quality improvement interventions have succeeded in improving the quality of palliative care delivery. More studies are needed on specific quality improvement types, including organizational change and multiple types of interventions.
authors.affiliation: 1Department of Surgery, Division of Acute Care Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Brandyn D
authors.initials: BD
authors.lastname: Lau
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Aslakson
authors.forename: Renee F
authors.initials: RF
authors.lastname: Wilson
authors.forename: Oluwakemi A
authors.initials: OA
authors.lastname: Fawole
authors.forename: Colleen C
authors.initials: CC
authors.lastname: Apostol
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Martinez
authors.forename: Daniela
authors.initials: D
authors.lastname: Vollenweider
authors.forename: Eric B
authors.initials: EB
authors.lastname: Bass
authors.forename: Sydney E Morss
authors.initials: SE
authors.lastname: Dy
mesh_terms: D006801:Humans; D010166:Palliative Care / Q000379:methods / Q000592:standards*; D058996:Quality Improvement; D011787:Quality of Health Care
keywords: comparative effectiveness; end of life; quality improvement; systematic review