Quality Indicators for Palliative Care: Update of a Systematic Review

Context. In 2007, a systematic review revealed a number of quality indicators
referring mostly to palliative care outcomes and processes. Psychosocial and
spiritual aspects were scarcely represented. Most publications lacked a detailed
description of the development process. With many initiatives and further
developments expected, an update is needed.
Objectives. This update gives an overview of the published quality indicators for
palliative care and identifies any new developments since 2007 regarding the
number and type of indicators developed and the methodology applied.
Methods. The same literature search as in the 2007 review was used to identify
relevant publications up to October 2011. Publications describing development
processes or characteristics of quality indicators for palliative care were selected by
two reviewers independently.
Results. The literature search resulted in 435 hits in addition to the 650 hits
found in the previous review. Thirteen new publications were selected in addition to
the 16 publications selected earlier, describing 17 sets of quality indicators containing
326 indicators. These cover all domains of palliative care as defined by the U.S.
NationalConsensus Project. Most indicators refer to care processes or outcomes.The
extent to which methodological characteristics are described varies widely.
Conclusion. Recent developments in measuring quality of palliative care using
quality indicators are mainly quantitative in nature, with a substantial number of
new indicators being found. However, the quality of the development process
varies considerably between sets. More consistent and detailed methodological
descriptions are needed for the further development of these indicators and
improved quality measurement of palliative care.