A multi-stage process to develop quality indicators for community-based palliative care using interRAI data

TitleA multi-stage process to develop quality indicators for community-based palliative care using interRAI data
Publication TypeJournal Article
Year of Publication2022
AuthorsGuthrie D.M, Williams N., Beach C., Buzath E., Cohen J., Declercq A., Fisher K., Fries B.E, Goodridge D., Hermans K., Hirdes J.P, Seow H., Silveira M., Sinnarajah A., Stevens S., Tanuseputro P., Taylor D., Vadeboncoeur C., Martin T.LW
JournalPLoS One
ISBN Number1932-6203
Accession Number35390091
Keywords*Home Care Services, *Palliative Care, Delphi Technique, Humans, North America, Quality Indicators, Health Care

BACKGROUND: Individuals receiving palliative care (PC) are generally thought to prefer to receive care and die in their homes, yet little research has assessed the quality of home- and community-based PC. This project developed a set of valid and reliable quality indicators (QIs) that can be generated using data that are already gathered with interRAI assessments-an internationally validated set of tools commonly used in North America for home care clients. The QIs can serve as decision-support measures to assist providers and decision makers in delivering optimal care to individuals and their families. METHODS: The development efforts took part in multiple stages, between 2017-2021, including a workshop with clinicians and decision-makers working in PC, qualitative interviews with individuals receiving PC, families and decision makers and a modified Delphi panel, based on the RAND/ULCA appropriateness method. RESULTS: Based on the workshop results, and qualitative interviews, a set of 27 candidate QIs were defined. They capture issues such as caregiver burden, pain, breathlessness, falls, constipation, nausea/vomiting and loneliness. These QIs were further evaluated by clinicians/decision makers working in PC, through the modified Delphi panel, and five were removed from further consideration, resulting in 22 QIs. CONCLUSIONS: Through in-depth and multiple-stakeholder consultations we developed a set of QIs generated with data already collected with interRAI assessments. These indicators provide a feasible basis for quality benchmarking and improvement systems for care providers aiming to optimize PC to individuals and their families. Copyright: © 2022 Guthrie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


PMC8989210 following competing interests: Dr. A. Sinnarajah has received research grants (last 5 years) on palliative care (as principal investigator or co-investigator), from the Canadian Institutes of Health Research, MSI Foundation, Canadian Cancer Society, Applied Research in Cancer Control, College of Family Physicians of Canada, Choosing Wisely Alberta, Alberta Innovates Health Research, Alberta Cancer Foundation, Alberta Health Services, University of Calgary, Canadian Frailty Network, Alberta Health and Campus Alberta Health Outcomes and Public Health. He has an academic appointment for palliative care research with Queen’s University and Lakeridge Health (currently), and University of Calgary (last 5 years). Lastly, he is/has paid medical administrative positions with Alberta Health Services and Lakeridge Health. The remaining authors declare that no competing interests exist. We confirm that Dr. Sinnarajah has some competing interests to report (previously detailed in the online submission) and we confirm that this does not alter our adherence to PLOS ONE policies on sharing data and materials.



Short TitlePLoS ONE