Evidence map›Paper›PMID 32336104›Full record

ArticleThe American journal of hospice & palliative care2020

Perceptions of Facilitators and Barriers to Measuring and Improving Quality in Palliative Care Programs.

Kamini Kuchinad, Ritu Sharma, Sarina R Isenberg, Nebras Abu Al Hamayel, Sallie J Weaver, Junya Zhu, Susan M Hannum, Arif H Kamal, Anne M Walling, Karl A Lorenz and 2 more

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In one paragraph

Article in The American journal of hospice & palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kamini Kuchinad1466Johns Hopkins School of Medicine, Baltimore, MD, USA.
Ritu SharmaDepartment of Health Policy and Management, 25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Sarina R IsenbergDepartment of Health Policy and Management, 25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID https://orcid.org/0000-0001-6059-5366
Nebras Abu Al HamayelDepartment of Health Policy and Management, 25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID https://orcid.org/0000-0001-6852-5055
Sallie J Weaver8383National Cancer Institute, Bethesda, MD, USA.
Junya Zhu1466Yale University, New Haven, CT, USA.
Susan M HannumDepartment of Health, Behavior and Society, 25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Arif H KamalDuke Cancer Institute and Duke Fuqua School of Business, 3065Duke University, Durham, NC, USA.
Anne M Walling19975VA Greater Los Angeles Health System, Los Angeles, CA, USA.
Karl A LorenzStanford School of Medicine, CA, USA.
Jonathan AilonDivision of Palliative Care, Department of Medicine, 7938University of Toronto, Ontario, Canada.
Sydney M Dy1466Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID https://orcid.org/0000-0001-6530-7415

Funding

Evaluation of Implementation of Point-of-Care Palliative Care Quality MeasuresR21CA197362 · NCI · JOHNS HOPKINS UNIVERSITY · PI DY, SYDNEY MORSS · 2016 to 2017
$388k
NCI NIH HHS R21 CA197362
6 · The paper itself

Abstract

objectiveTo examine perceptions of facilitators and barriers to quality measurement and improvement in palliative care programs and differences by professional and leadership roles.

methodsWe surveyed team members in diverse US and Canadian palliative care programs using a validated survey addressing teamwork and communication and constructs for educational support and training, leadership, infrastructure, and prioritization for quality measurement and improvement. We defined key facilitators as constructs rated ≥4 (agree) and key barriers as those ≤3 (disagree) on 1 to 5 scales. We conducted multivariable linear regressions for associations between key facilitators and barriers and (1) professional and (2) leadership roles, controlling for key program and respondent factors and clustering by program.

resultsWe surveyed 103 respondents in 11 programs; 45.6% were physicians and 50% had leadership roles. Key facilitators across sites included teamwork, communication, the implementation climate (or environment), and program focus on quality improvement. Key barriers included educational support and incentives, particularly for quality measurement, and quality improvement infrastructure such as strategies, systems, and skilled staff. In multivariable analyses, perceptions did not differ by leadership role, but physicians and nurse practitioners/nurses/physician assistants rated most constructs statistically significantly more negatively than other team members, especially for quality improvement (6 of the 7 key constructs).

conclusionsAlthough participants rated quality improvement focus and environment highly, key barriers included lack of infrastructure, especially for quality measurement. Building on these facilitators and measuring and addressing these barriers might help programs enhance palliative care quality initiatives' acceptability, particularly for physicians and nurses.

Indexed as

Palliative CareQuality ImprovementCanadaHumansPerceptionQuality of Health Carepalliative carequalityquality improvementquality measurement

Identifiers

PMID32336104
PMCPMC9700197

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Registered trials

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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.