42 What outcome domains are considered core to assessing the impact of adult specialist palliative care services in Wales?

Introduction

Assessment of palliative care services (PCS) is vital for managing and improving care delivery. Previous assessment of PCS has often focused on process related outcomes but there is increasing emphasis upon the need to measure quality and effectiveness of service delivery in healthcare. There are examples where a consensus driven approach has led to quality assessment toolkits (e.g. OACC in UK,¹ PCOC in Australia²) for PCS but there is a need to derive consensus on the key quality domains for assessing PCS in the context of Wales’ particular healthcare economy. This has been identified as a key priority for Wales.

Aims

To conduct a mapping evidence review to identify the most important outcome domains described within the literature for evaluating the quality and effectiveness of specialist adult palliative care services. These domains will then underpin a subsequent consensus process.

Method

Five key databases were searched for relevant published papers. Supplementary journal searches were also carried out. Methodology was used from the Palliative care Evidence Review Service (PaCERS)³ for most of this review, with some adaptations.

Results

Of 254 articles identified, 9 studies met the inclusion criteria. Core outcome domains identified included: structure and process of care, physical aspects of care and psychological/psychiatric aspects of care. These appeared to be of significance across most of the studies. Social aspects of care and ethical/legal aspects of care appeared to a lesser extent amongst the included domains.

Conclusion

The findings will inform future stages of a core outcome set project.

Impact

Results of the core outcome set project will be used to underpin an assessment process for PCS delivery across Wales.

References

Witt J, Murtagh FE, de Wolf-Linder S, Higginson IJ, Daveson BA. Introducing the outcome assessment and complexity collaborative (OACC) suite of measures-A brief introduction. Kings College London. 2014. Eagar K, Watters P, Currow DC, et al. The Australian palliative care outcomes collaboration (PCOC)–measuring the quality and outcomes of palliative care on a routine basis. Aust Health Rev 2010;34(2):186–192. Mann M, Woodward A, Nelson A, Byrne A. Palliative care evidence review service (PaCERS): a knowledge transfer partnership. Health Res Policy Sys 2019;17(1):100. https://doi.org/10.1186/s12961-019-0504-4