TY - JOUR

T1 - Organisation and Evaluation of General Palliative Care in a Danish Hospital

AU - Bergenholtz, Heidi

AU - Hølge-Hazelton, Bibi

AU - Jarlbæk, Lene

PY - 2015/5/26

Y1 - 2015/5/26

N2 - Background: Hospitals have a responsibility to ensure that palliative care is provided to all patients with life-threatening illnesses. Generalist palliative care should therefore be acknowledged and organized as a partof the clinical tasks. However, little is known about the organization and evaluation of generalist palliative care in hospitals. Therefore the aim of the study was to investigate the organization and evaluation of generalist palliative care in a large regional hospital by comparing results from existing evaluations.Methods: Results from three different data sets, all aiming to evaluate generalist palliative care, were compared retrospectively. The data-sets derived from; 1. a national accreditation of the hospital, 2. a national survey and 3. aninternal self-evaluation performed in the hospital. The data were triangulated to investigate the organization andevaluation of palliative care in order to identify concordances and/or discrepancies.Results: The triangulation indicated poor validity of the results from existing methods used to evaluate palliativecare in hospitals. When the datasets were compared, several discrepancies occurred with regard to the organizationand the performance of generalist palliative care. Five types of discrepancies were found in 35 out of 56 sections inthe fulfilment of the national accreditation standard for palliative care. Responses from the hospital management and the department managements indicated that generalist palliative care was organized locally – if at all – withinthe various departments and with no overall structure or policy.Conclusions: This study demonstrates weaknesses in the existing evaluation methods for generalist palliative care and highlights the lack of an overall policy, organization and goals for the provision of palliative care in the hospital. More research is needed to focus on the organization of palliative care and to establish indicators for highquality palliative care provided by the hospital. The lack of valid indicators, both for the hospital’s and the departments’ provision of palliative care, calls for more qualitative insight in the clinical staff’s daily work includingtheir culture and acceptance of the provision of palliative care.

AB - Background: Hospitals have a responsibility to ensure that palliative care is provided to all patients with life-threatening illnesses. Generalist palliative care should therefore be acknowledged and organized as a partof the clinical tasks. However, little is known about the organization and evaluation of generalist palliative care in hospitals. Therefore the aim of the study was to investigate the organization and evaluation of generalist palliative care in a large regional hospital by comparing results from existing evaluations.Methods: Results from three different data sets, all aiming to evaluate generalist palliative care, were compared retrospectively. The data-sets derived from; 1. a national accreditation of the hospital, 2. a national survey and 3. aninternal self-evaluation performed in the hospital. The data were triangulated to investigate the organization andevaluation of palliative care in order to identify concordances and/or discrepancies.Results: The triangulation indicated poor validity of the results from existing methods used to evaluate palliativecare in hospitals. When the datasets were compared, several discrepancies occurred with regard to the organizationand the performance of generalist palliative care. Five types of discrepancies were found in 35 out of 56 sections inthe fulfilment of the national accreditation standard for palliative care. Responses from the hospital management and the department managements indicated that generalist palliative care was organized locally – if at all – withinthe various departments and with no overall structure or policy.Conclusions: This study demonstrates weaknesses in the existing evaluation methods for generalist palliative care and highlights the lack of an overall policy, organization and goals for the provision of palliative care in the hospital. More research is needed to focus on the organization of palliative care and to establish indicators for highquality palliative care provided by the hospital. The lack of valid indicators, both for the hospital’s and the departments’ provision of palliative care, calls for more qualitative insight in the clinical staff’s daily work includingtheir culture and acceptance of the provision of palliative care.

U2 - 10.1186/s12904-015-0022-2

DO - 10.1186/s12904-015-0022-2

M3 - Journal article

C2 - 25943367

VL - 14

SP - 1

EP - 11

JO - BMC Palliative Care

JF - BMC Palliative Care

SN - 1472-684X

M1 - 23

ER -