ArticleBMC palliative care2016
Improving palliative care in selected settings in England using quality indicators: a realist evaluation.
Article in BMC palliative care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- An evidence-base for the implementation of hospital-based palliative care programs in routine cancer practice: A systematic review.Palliative medicine · 2023Pooled it
- Quality indicators for Palliative Day Services: A modified Delphi study.Palliative medicine · 2019Pooled it
- Describing and monitoring quality in value-based palliative and end-of-life care at a population level in Wales: achievements and future direction.BMJ supportive & palliative care · 2026Article
- Quality indicators of palliative care for cardiovascular intensive care.Journal of intensive care · 2022Review
- Level of Knowledge and Attitudes Towards Palliative Care for People with Advanced Dementia in Spain: Role of Professional and Academic Factors.Current Alzheimer research · 2022Article
- Large differences in the organization of palliative care in nursing homes in six European countries: findings from the PACE cross-sectional study.BMC palliative care · 2021Article
- Introducing the trajectory Touchpoint technique: a systematic methodology for capturing the service experiences of palliative care patients and their families.BMC palliative care · 2020Article
- The Impact of Measuring Patient-Reported Outcome Measures on Quality of and Access to Palliative Care.Journal of palliative medicine · 2018Review
- Compassionate collaborative care: an integrative review of quality indicators in end-of-life care.BMC palliative care · 2017Review
- Identifying models of delivery, care domains and quality indicators relevant to palliative day services: a scoping review protocol.Systematic reviews · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a gap between readily available evidence of best practice and its use in everyday palliative care. The IMPACT study evaluated the potential of facilitated use of Quality Indicators as tools to improve palliative care in different settings in England.
methods1) Modelling palliative care services and selecting a set of Quality Indicators to form the core of an intervention, 2) Case studies of intervention using the Quality Indicator set supported by an expert in service change in selected settings (general practice, community palliative care teams, care homes, hospital wards, in-patient hospices) with a before-and-after evaluation, and 3) realist evaluation of processes and outcomes across settings. Participants in each setting were supported to identify no more than three Quality Indicators to work on over an eight-month period in 2013/2014.
resultsGeneral practices could not be recruited to the study. Care homes were recruited but not retained. Hospital wards were recruited and retained, and using the Quality Indicator (QI) set achieved some of their desired changes. Hospices and community palliative care teams were able to use the QI set to achieve almost all their desired changes, and develop plans for quality improvements. Improvements included: increasing the utility of electronic medical records, writing a manual for end of life care, establishing working relationships with a hospice; standardising information transfer between settings, holding regular multi-disciplinary team meetings, exploration of family carers' views and experiences; developing referral criteria, and improvement of information transfer at patient discharge to home or to hospital. Realist evaluation suggested that: 1) uptake and use of QIs are determined by organisational orientation towards continuous improvement; 2) the perceived value of a QI package was not powerful enough for GPs and care homes to commit to or sustain involvement; 3) the QI set may have been to narrow in focus, or more specialist than generalist; and 4) the greater the settings' 'top-down' engagement with this change project, the more problematic was its implementation.
conclusionsWhilst use of QIs may facilitate improvements in specialist palliative care services, different QI sets may be needed for generalist care settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.