title: Creation of Minimum Standard Tool for Palliative Care in India and Self-evaluation of Palliative Care Programs Using It.
abstract: BACKGROUND
  It is important to ensure that minimum standards for palliative care based on available resources are clearly defined and achieved.
  
  
  OBJECTIVE
  (1) Creation of minimum National Standards for Palliative Care for India. (2) Development of a tool for self-evaluation of palliative care organizations. (3) Evaluation of the tool in India. In 2006, Pallium India assembled a working group at the national level to develop minimum standards. The standards were to be evaluated by palliative care services in the country.
  
  
  METHODS
  The working group prepared a "standards" document, which had two parts - the first composed of eight "essential" components and the second, 22 "desirable" components. The working group sent the document to 86 hospice and palliative care providers nationwide, requesting them to self-evaluate their palliative care services based on the standards document, on a modified Likert scale.
  
  
  RESULTS
  Forty-nine (57%) palliative care organizations responded, and their self-evaluation of services based on the standards tool was analyzed. The majority of the palliative care providers met most of the standards identified as essential by the working group. A variable percentage of organizations had satisfied the desirable components of the standards.
  
  
  CONCLUSIONS
  We demonstrated that the "standards tool" could be applied effectively in practice for self-evaluation of quality of palliative care services.
authors.affiliation: Director, WHO Collaborating Centre for Policy and Training on Access to Pain Relief, Pallium India, Trivandrum, Kerala, India.
authors.forename: Mr
authors.initials: M
authors.lastname: Rajagopal
authors.affiliation: Department of Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India.
authors.forename: Anjum Khan
authors.initials: AK
authors.lastname: Joad
authors.affiliation: Professor and Head of Palliative Medicine, Tata Memorial Cancer Hospital, Mumbai, Maharashtra, India.
authors.forename: Maryann
authors.initials: M
authors.lastname: Muckaden
authors.affiliation: Department of Palliative Care, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Reena
authors.initials: R
authors.lastname: George
authors.affiliation: Founder-President, Can Support, New Delhi, India.
authors.forename: Harmala
authors.initials: H
authors.lastname: Gupta
authors.affiliation: Head of Palliative Care, Makerere University, Kampala, Uganda, Medical Director Cairdeas International Palliative Care Trust, Scotland.
authors.forename: Mhoira Ef
authors.initials: ME
authors.lastname: Leng
authors.affiliation: Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, Andhra Pradesh, India.
authors.forename: Gayatri
authors.initials: G
authors.lastname: Palat
authors.affiliation: Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Firuza
authors.initials: F
authors.lastname: Patel
authors.affiliation: Department of Palliative Care, Kerala Institute of Medical Sciences (KIMS), Trivandrum, Kerala, India.
authors.forename: Biju
authors.initials: B
authors.lastname: Raghavan
authors.affiliation: Department of Palliative Care, University Of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Suresh K
authors.initials: SK
authors.lastname: Reddy
authors.affiliation: Department of Training, Alpha Palliative Care, Edamuttam, Thrissur, Kerala, India.
authors.forename: Mm
authors.initials: M
authors.lastname: Sunilkumar
authors.affiliation: Managing Trustee, Lakshmi Pain and Palliative Care Trust, Adjunct Professor, The Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India.
authors.forename: Mallika
authors.initials: M
authors.lastname: Tiruvadanan
authors.affiliation: Worldwide Palliative Care Alliance, Washington, USA.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Connor
keywords: Audit; Developing countries; Hospice care; India; Limited resources; National standards; Palliative care; Quality assurance; Quality improvement