Quality assessment of palliative home care in Italy

Scaccabarozzi, Gianlorenzo; Lovaglio, Pietro Giorgio; Limonta, Fabrizio; Floriani, Maddalena; Pellegrini, Giacomo

doi:10.1111/jep.12704

Cited by 12 publications

(14 citation statements)

References 25 publications

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“…Los indicadores de resultado miden el éxito de la atención en salud brindada al paciente (14). Se incluyeron 24 indicadores que fueron extraídos de 8 artículos (16)(17)(18)20,(22)(23)(24)(25), uno de los indicadores presento 5 formas de ser medido. Los indicadores mencionados con mayor frecuencia fueron: porcentaje de muerte en el hogar, presencia de dolor disruptivo aun con medicación, presencia de angustia en el cuidador, prevalencia de estado de ánimo negativo y presencia de aislamiento social.…”

Section: Indic Adores De Results Adounclassified

“…Durante la revisión se encontró q ue los 9 indicadores de estr uctura se miden con preguntas cerradas con opciones de respuesta negativa o afir mativa. En los dos artículos q ue contem plan este tipo de indicadores (15,16) Evaluación de la calidad de los servicios de cuidados paliativos domiciliarios: revisión de la literatura | Yahel-Tatiana Mejía-R., Amine-Yulie Carlier-S. Claudia-Marcela Vargas-M., Karen-Johanna López-P., Genny-Paola Fuentes-B. e025 se plantean indicadores relacionados con la existencia de personal calificado para la atención en cuidados paliativos y evalúan la interdisciplinariedad, así co m o la for mación y capacitación continua del personal; sin em bargo, en ninguno de ellos se plantea la relación entre la cantidad del recurso humano, ya sea personal médico o de enfer mería, y el número de pacientes atendidos.…”

Section: Indic Adores De Es T Ruc Turaunclassified

“…Variación semanal de la proporción de intensidad de atención en las 3 semanas previas a la muerte en el hogar En su estudio, Scaccabarozzi et ál. destacan indicadores relacionados con entrevistas a cuidadores, capacitación continua del personal asistencial (médico y enfer mería), provisión de inter venciones m ultidisciplinarias especializadas, apoyo psicológico y suministros de medicación en el hogar (16).…”

Section: Número Total De Pacientes Inscritos En El Programaunclassified

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Evaluación de la calidad de los servicios de cuidados paliativos domiciliarios: revisión de la literatura

Mejia¹,

Salcedo

Martínez

et al. 2020

Rev. Colomb. Enferm.

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Introducción: La calidad de los servicios de salud se mide con indicadores que permiten encontrar oportunidades de mejora, datos clínicos y no clínicos de relevancia, información epidemiológica y calidad percibida del servicio brindado. Los cuidados paliativos pueden ofrecerse en distintas modalidades, siendo los cuidados domiciliarios una ruta novedosa que permite el cuidado del paciente lejos del intervencionismo hospitalario; los indicadores que evalúan la calidad de esta modalidad varían respecto a los servicios intramurales. Objetivo: describir los indicadores de calidad en salud utilizados para evaluar los servicios de cuidados paliativos domiciliarios según la literatura consultada. Método: revisión sistemática de la literatura científica disponible sobre los indicadores de calidad en salud para los cuidados paliativos domiciliarios. Para valorar la calidad metodológica se usó la lista CASPe. Resultados: se encontraron 47 indicadores que evalúan la calidad de los servicios de atención domiciliaria paliativa, siendo los indicadores de resultados los que tuvieron mayor presencia. Dentro de los indicadores se midieron diversos aspectos de los cuidados paliativos como manejo de síntomas, visitas domiciliarias por personal especializado, lugar de muerte elegido, eventos relacionados con la seguridad del paciente y disponibilidad de medicamentos. Conclusiones: La medición del lugar de fallecimiento y la presencia de síntomas aun con un tratamiento farmacológico establecido fueron dos de los indicadores más encontrados. Se observó una medición al personal médico y enfermero superior al resto de profesionales que conforman el equipo multidisciplinario de cuidados paliativos, se encontraron algunos indicadores específicos para pacientes con patologías oncológicas.

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Section: Indic Adores De Results Adounclassified

Section: Indic Adores De Es T Ruc Turaunclassified

Section: Número Total De Pacientes Inscritos En El Programaunclassified

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Evaluación de la calidad de los servicios de cuidados paliativos domiciliarios: revisión de la literatura

Mejia¹,

Salcedo

Martínez

et al. 2020

Rev. Colomb. Enferm.

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“…The relatively high scores in Belgium may be explained by the well-established palliative home care teams and region-wide palliative care networks that promote collaboration and sharing of knowledge and expertise with GPs. 30 31 In Italy, on the other hand, palliative home care is still mainly provided to people with cancer, 32 which may contribute to lower quality indicator scores for the population included in this study. The differences between Belgium and Spain were not consistently in the same direction.…”

Section: Discussionmentioning

confidence: 99%

Primary palliative care for older people in three European countries: a mortality follow-back quality study

Nooijer

Pivodic

Deliëns

et al. 2019

BMJ Support Palliat Care

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background Many older people with serious chronic illnesses experience complex health problems for which palliative care is indicated. We aimed to examine the quality of primary palliative care for people aged 65-84 years and those 85 years and older who died non-suddenly in three European countries. Methods This is a nationwide representative mortality follow-back study. General practitioners (GPs) belonging to epidemiological surveillance networks in Belgium (BE), Italy (IT) and Spain (ES) (2013-2015) registered weekly all deaths in their practices. We included deaths of people aged 65 and excluded sudden deaths judged by GPs. We applied a validated set of quality indicators. results GPs registered 3496 deaths, of which 2329 were non-sudden (1126 aged 65-84, 1203 aged 85+). GPs in BE (reference category) reported higher scores than IT across almost all indicators. Differences with ES were not consistent. The score in BE particularly differed from IT on GP-patient communication (aged 65-84: 61% in BE vs 20% in IT (OR=0.12, 95% CI 0.07 to 0.20) aged 85+: 47% in BE vs 9% in IT (OR=0.09, 95% CI 0.05 to 0.16)). Between BE and ES, we identified a large difference in involvement of palliative care services (aged 65-84: 62% in BE vs 89% in ES (OR=4.81, 95% CI 2.41 to 9.61) aged 85+: 61% in BE vs 77% in ES (OR=3.1, 95% CI 1.71 to 5.53)). conclusions Considerable country differences were identified in the quality of primary palliative care for older people. The data suggest room for improvement across all countries, particularly regarding pain measurement, GP-patient communication and multidisciplinary meetings. copyright.on July 11, 2020 by guest. Protected by

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“…The other method conducted by Scaccabarozzi studied on the assessment of end of life service quality in a home palliative care using the method of Rasch analysis. This identified 5 indicators easy to use by the health care providers: “interview with the caregivers, sustainable training for the medical and nursing staffs, intervention by multidisciplinary specialists, psychological support to the patient and family, supply of medicines at home) and identified 3 problematic indicators (the availability of regulation on local network of palliative care as the reference, the needs on the care in most of the problematic patients who needed high-intensity care, and the percentage of cancer patient died at home) [8]. This method of analysis was able to reveal which indicators could be achieved and which indicators that needed extra efforts to be achieved.…”

Section: Discussionmentioning

confidence: 99%

Modified Delphi Consensus on Developing Home Care Service Quality Indicator for Stroke Survivor in Yogyakarta, Indonesia

Chayati¹,

Effendy²,

Setyopranoto³

2019

Open Access Maced J Med Sci

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BACKGROUND: Assessing the quality of health services provided at home (home care) is a challenge. The formulation of indicators requires open-minded people, who able to formulate several purposes objectively, and play an active role in decision making. PURPOSE: To test the face validity of the home care quality indicator in stroke patients with the modified Delphi method. METHOD: Eighty-one indicators generated from previous studies were assessed using 3 processes to get the final results: 1) conducted modified Delphi in two rounds, namely rating or scoring by experts (using median scores); 2) reviewing qualitative suggestions from experts during the Delphi process (using comments from both Delphi rounds); 3) sorting out and correcting the grammar of the appropriate indicator (based on the median score > 7, and no disagreement). RESULT: Eighty-seven experts were involved in the first round Delphi and 34 experts in the second round. The experts were home care team selected from health care institutions in Yogyakarta with various professional backgrounds. Delphi process resulted in 67 indicators from 81 indicators which were divided into 10 domains: 1) Personal (2 indicators), 2) Documents (13 indicators), 3) Professionalism development (3 indicators), 4) Supporting facilities (8 indicators), 5) Administrative activities (4 indicators), 6) Health workers interaction with patients and families (15 indicators), 7) Physical conditions (2 indicators), 8) Self-actualization (1 indicator), 9) Psychological condition (5 indicators), 10) Family independent and coping (14 indicators). Selected indicators got to score more than 7 and no disagreement at all. CONCLUSION: Sixty-seven indicators of the quality of home care, which were generated from modified Delphi consensus, were face validated. Further research could be conducted particularly on the trial process of these indicators at the actual home dwelling service setting.

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Quality assessment of palliative home care in Italy

Abstract: The lack of Local Network of Palliative care, required by law 38/2010, is, at the present, the main barrier to its application. However, the adopted methodology suggests that a clear roadmap for health facilities to afford future quality and normative challenges.

Cited by 12 publications

References 25 publications

Evaluación de la calidad de los servicios de cuidados paliativos domiciliarios: revisión de la literatura

Evaluación de la calidad de los servicios de cuidados paliativos domiciliarios: revisión de la literatura

Primary palliative care for older people in three European countries: a mortality follow-back quality study

Modified Delphi Consensus on Developing Home Care Service Quality Indicator for Stroke Survivor in Yogyakarta, Indonesia

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