title: Assessment of a Hospital Palliative Care Unit (HPCU) for Cancer Patients; A Conceptual Framework.
abstract: BACKGROUND
  The first hospital palliative care unit (HPCU) in Iran (FARS-HPCU) has been established in 2008 in the Cancer Institute, which is the largest referral cancer center in the country. We attempted to assess the performance of the HPCU based on a comprehensive conceptual framework. The main aim of this study was to develop a conceptual framework for assessment of the HPCU performances through designing a value chain in line with the goals and the main processes (core and support).
  
  
  METHODS
  We collected data from a variety of sources, including international guidelines, international best practices, and expert opinions in the country and compared them with national policies and priorities. We also took into consideration the trend of the HPCU development in the Cancer Institute of Iran. Through benchmarking the gap area with the performance standards, some recommendations for better outcome are proposed.
  
  
  RESULTS
  The framework for performance assessment consisted of 154 process indicators (PIs), based on which the main stakeholders of the HPCU (including staff, patients, and families) offered their scoring. The outcome revealed the state of the processes as well as the gaps.
  
  
  CONCLUSIONS
  Despite a significant improvement in many processes and indicators, more development in the comprehensive and integrative aspects of FARS-HPCU performance is required. Consideration of all supportive and palliative requirements of the patients through interdisciplinary and collaborative approaches is recommended.
authors.affiliation: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Rouhollahi
authors.affiliation: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran ; Department of Anesthesiology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Saghafinia
authors.affiliation: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Kazem
authors.initials: K
authors.lastname: Zandehdel
authors.affiliation: Department of Radiotherapy, Shahid Baheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali Ghanbari
authors.initials: AG
authors.lastname: Motlagh
authors.affiliation: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Kazemian
authors.affiliation: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Mohagheghi
authors.affiliation: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mamak
authors.initials: M
authors.lastname: Tahmasebi
keywords: Cancer; Conceptual framework; Hospital palliative care unit; Palliative care; Value chain; performance assessment