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Toward population-based indicators of quality end-of-life care: testing stakeholder agreement.

Publication ,  Journal Article
Grunfeld, E; Urquhart, R; Mykhalovskiy, E; Folkes, A; Johnston, G; Burge, FI; Earle, CC; Dent, S
Published in: Cancer
May 15, 2008

BACKGROUND: Quality indicators (QIs) are tools designed to measure and improve quality of care. The objective of this study was to assess stakeholder acceptability of QIs of end-of-life (EOL) care that potentially were measurable from population-based administrative health databases. METHODS: After a literature review, the authors identified 19 candidate QIs that potentially were measurable through administrative databases. A modified Delphi methodology, consisting of multidisciplinary panels of cancer care health professionals in Nova Scotia and Ontario, was used to assess agreement on acceptable QIs of EOL care (n = 21 professionals; 2 panels per province). Focus group methodology was used to assess acceptability among patients with metastatic breast cancer (n = 16 patients; 2 groups per province) and bereaved family caregivers of women who had died of metastatic breast cancer (n = 8 caregivers; 1 group per province). All sessions were audiotaped, transcribed verbatim, and audited, and thematic analyses were conducted. RESULTS: Through the Delphi panels, 10 QIs and 2 QI subsections were identified as acceptable indicators of quality EOL care, including those related to pain and symptom management, access to care, palliative care, and emergency room visits. When Delphi panelists did not agree, the principal reasons were patient preferences, variation in local resources, and benchmarking. In the focus groups, patients and family caregivers also highlighted the need to consider preferences and local resources when examining quality EOL care. CONCLUSIONS: The findings of this study should be considered when developing quality monitoring systems. QIs will be most useful when stakeholders perceive them as measuring quality care.

Duke Scholars

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

May 15, 2008

Volume

112

Issue

10

Start / End Page

2301 / 2308

Location

United States

Related Subject Headings

  • Terminal Care
  • Quality of Life
  • Quality of Health Care
  • Quality Indicators, Health Care
  • Palliative Care
  • Oncology & Carcinogenesis
  • Nova Scotia
  • Medical Records
  • Humans
  • Female
 

Citation

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Chicago
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Grunfeld, E., Urquhart, R., Mykhalovskiy, E., Folkes, A., Johnston, G., Burge, F. I., … Dent, S. (2008). Toward population-based indicators of quality end-of-life care: testing stakeholder agreement. Cancer, 112(10), 2301–2308. https://doi.org/10.1002/cncr.23428
Grunfeld, Eva, Robin Urquhart, Eric Mykhalovskiy, Amy Folkes, Grace Johnston, Frederick I. Burge, Craig C. Earle, and Susan Dent. “Toward population-based indicators of quality end-of-life care: testing stakeholder agreement.Cancer 112, no. 10 (May 15, 2008): 2301–8. https://doi.org/10.1002/cncr.23428.
Grunfeld E, Urquhart R, Mykhalovskiy E, Folkes A, Johnston G, Burge FI, et al. Toward population-based indicators of quality end-of-life care: testing stakeholder agreement. Cancer. 2008 May 15;112(10):2301–8.
Grunfeld, Eva, et al. “Toward population-based indicators of quality end-of-life care: testing stakeholder agreement.Cancer, vol. 112, no. 10, May 2008, pp. 2301–08. Pubmed, doi:10.1002/cncr.23428.
Grunfeld E, Urquhart R, Mykhalovskiy E, Folkes A, Johnston G, Burge FI, Earle CC, Dent S. Toward population-based indicators of quality end-of-life care: testing stakeholder agreement. Cancer. 2008 May 15;112(10):2301–2308.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

May 15, 2008

Volume

112

Issue

10

Start / End Page

2301 / 2308

Location

United States

Related Subject Headings

  • Terminal Care
  • Quality of Life
  • Quality of Health Care
  • Quality Indicators, Health Care
  • Palliative Care
  • Oncology & Carcinogenesis
  • Nova Scotia
  • Medical Records
  • Humans
  • Female