New resource to help improve day services for people living with a terminal illness

Researchers have published the first set of indicators to help measure the quality and impact of palliative day services across the UK, ensuring people get the best care and support at the end of life.

The research, funded by terminal illness charity Marie Curie, enables palliative day service providers to effectively describe and evaluate the quality of their care for the first time, whilst also identifying areas for quality improvement.

Palliative day services provided by hospices are designed to offer holistic care that contributes to the quality of life of people with terminal illness and their families. Until now, there has been no published standard on what these services should look like and how to demonstrate their effectiveness in supporting patients and families.

The researchers hope that the new standards will help staff to understand the best way to care for people with complex needs and their families, at a time when demand is growing and resources are limited.

As part of the research, a panel of experts from hospices and universities across the UK independently reviewed the evidence relating to 182 possible indicators and provided ratings on their appropriateness, feasibility, and necessity. From this, 30 indicators were identified as a starting point for quality improvement, which were compiled into a ‘toolkit’ and tested in five palliative day services settings in the UK.

Dr Noleen McCorry, Queens University Belfast, and lead author of the research, said:“We carried out this research as there was no published standard for evaluating day services, so there was no way of determining the quality of a service. We believe these indicators can enable service providers to measure the quality of their care, allowing them to identify areas for improvement and ultimately provide a better-quality service for patients. It’s also important that services will be able to demonstrate improvement, whendealing with key stakeholders and commissioners for further services, securing the future of better palliative care services.”

Julie Pearce, Marie Curie Executive Director of Nursing, Allied Health Professionals and Quality, said:“This is the first time that a qualitative approach has been used to develop quality indicators for day services and that’s a step in the right direction. Day services make an important contribution to the palliative care experience of patients; future provision is likely to expand to enable more people to access specialist palliative care and support. These indicators could help shape services, whilst also demonstrating their effectiveness in supporting the patient and family.”

Dr Paul Perkins, Interim Chief Medical Director at Sue Ryder and co-author of the research, said: “Sue Ryder hopes that these measures will help hospices to reflect on how best they can drive improvement in the day services they are providing.

"We were delighted to be part of this research, working with colleagues from across the UK so we can all bring our expertise to ensure we deliver the highest standards of care. We hope to be able to work with them again on other projects in the future." 

The researchers are now working towards creating an online toolkit, that will make improvements easier to assess and work towards.

The study titled Quality Indicators for Palliative Day Services: A modified Delphi Study was published in Palliative Medicine.  The full research paper can be accessed at https://doi.org/10.1177/0269216318810601