Williams Nicole, Boumans Nicole, Luymes Nicole, White Nancy E, Lemonde Manon, Guthrie Dawn M
Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada.
Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.
Palliat Support Care. 2022 Apr;20(2):226-232. doi: 10.1017/S1478951521000791.
The need for palliative care (PC) will continue to increase in Canada with population aging. Many older adults prefer to "age in place" and receive care in their own homes. Currently, there is a lack of standardized quality indicators (QIs) for PC delivered in the community in Canada.
A one-day workshop collected expert opinions on what should be measured to capture quality PC. Three brainstorming sessions were focused on addressing the following questions: (1) what is important to measure to support quality PC, regardless of setting? (2) Of the identified measures, are any of special importance to care provided in the home? (3) What are the challenges, barriers, and opportunities for creating these measures? The National Consensus Project (NCP) for Quality Palliative Care framework was used as a guide to group together important comments into key themes.
The experts identified four themes that are important for measuring quality, regardless of care setting, including access to care in the community by a multidisciplinary team, care for the individual with PC needs, support for the informal caregiver (e.g., family, friends), and symptom management for individuals with PC needs. Two additional themes were of special importance to measuring quality PC in the home, including spiritual care for individuals with PC needs and home as the preferred place of death. The challenges, barriers, and potential opportunities to these quality issues were also discussed.
PC experts, through this collaborative process, made a substantial contribution to the creation of a standardized set of QIs for community-based PC. Having a standardized set of QIs will enable health care professionals and decision makers to target areas for improvement, implement interventions to improve the quality of care, and ultimately, optimize the health and well-being of individuals with a serious illness.
随着加拿大人口老龄化，对姑息治疗（PC）的需求将持续增加。许多老年人更喜欢“就地养老”并在自己家中接受护理。目前，加拿大社区提供的姑息治疗缺乏标准化的质量指标（QIs）。
举办了为期一天的研讨会，收集关于衡量高质量姑息治疗应涵盖哪些内容的专家意见。三次头脑风暴会议聚焦于解决以下问题：（1）无论环境如何，衡量以支持高质量姑息治疗的重要内容是什么？（2）在已确定的衡量指标中，是否有对家庭护理特别重要的？（3）制定这些指标面临哪些挑战、障碍和机遇？以国家姑息治疗质量共识项目（NCP）框架为指导，将重要意见归纳为关键主题。
专家们确定了四个对衡量质量很重要的主题，无论护理环境如何，包括多学科团队在社区提供护理、对有姑息治疗需求的个人的护理、对非正式护理者（如家人、朋友）的支持以及对有姑息治疗需求的个人的症状管理。另外两个主题对衡量家庭中的高质量姑息治疗特别重要，包括对有姑息治疗需求的个人的精神护理以及家庭作为首选死亡地点。还讨论了这些质量问题面临的挑战、障碍和潜在机遇。
姑息治疗专家通过这一协作过程，为创建一套基于社区的姑息治疗标准化质量指标做出了重大贡献。拥有一套标准化的质量指标将使医疗保健专业人员和决策者能够确定需要改进的领域，实施干预措施以提高护理质量，并最终优化重症患者的健康和福祉。
