Palliative Care Quality Indicators for Patients with End-Stage Liver Disease Due to Cirrhosis

the Palliative Care Cirrhosis Quality Expert Panel

doi:10.1007/s10620-016-4339-3

Palliative Care Quality Indicators for Patients with End-Stage Liver Disease Due to Cirrhosis

the Palliative Care Cirrhosis Quality Expert Panel

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

Background and Aims: There are guidelines for the medical management of cirrhosis and associated quality indicators (QIs), but QIs focusing on standards for palliative aspects of care are needed. Methods: We convened a 9-member, multidisciplinary expert panel and used RAND/UCLA modified Delphi methods to develop palliative care quality indicators for patients with cirrhosis. Experts were provided with a report based on a systematic review of the literature that contained evidence concerning the proposed candidate QIs. Panelists rated QIs prior to a planned meeting using a standard 9-point RAND appropriateness scale. These ratings guided discussion during a day-long phone conference meeting, and final ratings were then provided by panel members. Final QI scores were computed and QIs with a final median score of greater than or equal to 7, and no disagreement was included in the final set. Results: Among 28 candidate QIs, the panel rated 19 as valid measures of quality care. These 19 quality indicators cover care related to information and care planning (13) and supportive care (6). Conclusions: These QIs are evidence-based process measures of care that may be useful to improve the quality of palliative care. Research is needed to better understand the quality of palliative care provided to patients with cirrhosis.

Original language	English (US)
Pages (from-to)	84-92
Number of pages	9
Journal	Digestive diseases and sciences
Volume	62
Issue number	1
DOIs	https://doi.org/10.1007/s10620-016-4339-3
State	Published - Jan 1 2017

Keywords

End-stage liver disease
Palliative care
Quality

ASJC Scopus subject areas

Physiology
Gastroenterology

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10.1007/s10620-016-4339-3

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@article{800a5c2387204fbb9c2919d0540eb38e,

title = "Palliative Care Quality Indicators for Patients with End-Stage Liver Disease Due to Cirrhosis",

abstract = "Background and Aims: There are guidelines for the medical management of cirrhosis and associated quality indicators (QIs), but QIs focusing on standards for palliative aspects of care are needed. Methods: We convened a 9-member, multidisciplinary expert panel and used RAND/UCLA modified Delphi methods to develop palliative care quality indicators for patients with cirrhosis. Experts were provided with a report based on a systematic review of the literature that contained evidence concerning the proposed candidate QIs. Panelists rated QIs prior to a planned meeting using a standard 9-point RAND appropriateness scale. These ratings guided discussion during a day-long phone conference meeting, and final ratings were then provided by panel members. Final QI scores were computed and QIs with a final median score of greater than or equal to 7, and no disagreement was included in the final set. Results: Among 28 candidate QIs, the panel rated 19 as valid measures of quality care. These 19 quality indicators cover care related to information and care planning (13) and supportive care (6). Conclusions: These QIs are evidence-based process measures of care that may be useful to improve the quality of palliative care. Research is needed to better understand the quality of palliative care provided to patients with cirrhosis.",

keywords = "End-stage liver disease, Palliative care, Quality",

author = "{the Palliative Care Cirrhosis Quality Expert Panel} and Walling, {A. M.} and Ahluwalia, {S. C.} and Wenger, {N. S.} and M. Booth and Roth, {C. P.} and K. Lorenz and F. Kanwal and S. Dy and Asch, {S. M.}",

note = "Funding Information: We acknowledge the significant contributions of the Palliative Care Cirrhosis Expert Panel including Bruce Bacon, MD, Sydney Dy, MD, MSc, Douglas Heuman, MD, Fasiha Kanwal, MD, MSHS, Timothy Morgan, MD, Teryl Nuckols, MD, MSHS, David Ross, MD, PhD, Tamar Taddei, MD, and Neil Wenger, MD, MPH. We appreciate the administrative support of Patricia Smith. We also appreciate the support of the VA HIV/Hepatitis QUERI and VA HSR&D (PPO 14-372). Dr. Walling was also supported by UCLA CTSI Grant Number UL1TR000124 and the NIH Loan Repayment Program. Funding Information: This project was supported by the HIV/Hepatitis QUERI, Veterans Administration and VA HSR&D (PPO 14-372). Dr. Walling was also supported by NIH/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number (UL1TR000124) and the NIH loan repayment program. Publisher Copyright: {\textcopyright} 2016, Springer Science+Business Media New York (Outside the USA).",

year = "2017",

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doi = "10.1007/s10620-016-4339-3",

language = "English (US)",

volume = "62",

pages = "84--92",

journal = "Digestive diseases and sciences",

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T1 - Palliative Care Quality Indicators for Patients with End-Stage Liver Disease Due to Cirrhosis

AU - the Palliative Care Cirrhosis Quality Expert Panel

AU - Walling, A. M.

AU - Ahluwalia, S. C.

AU - Wenger, N. S.

AU - Booth, M.

AU - Roth, C. P.

AU - Lorenz, K.

AU - Kanwal, F.

AU - Dy, S.

AU - Asch, S. M.

N1 - Funding Information: We acknowledge the significant contributions of the Palliative Care Cirrhosis Expert Panel including Bruce Bacon, MD, Sydney Dy, MD, MSc, Douglas Heuman, MD, Fasiha Kanwal, MD, MSHS, Timothy Morgan, MD, Teryl Nuckols, MD, MSHS, David Ross, MD, PhD, Tamar Taddei, MD, and Neil Wenger, MD, MPH. We appreciate the administrative support of Patricia Smith. We also appreciate the support of the VA HIV/Hepatitis QUERI and VA HSR&D (PPO 14-372). Dr. Walling was also supported by UCLA CTSI Grant Number UL1TR000124 and the NIH Loan Repayment Program. Funding Information: This project was supported by the HIV/Hepatitis QUERI, Veterans Administration and VA HSR&D (PPO 14-372). Dr. Walling was also supported by NIH/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number (UL1TR000124) and the NIH loan repayment program. Publisher Copyright: © 2016, Springer Science+Business Media New York (Outside the USA).

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background and Aims: There are guidelines for the medical management of cirrhosis and associated quality indicators (QIs), but QIs focusing on standards for palliative aspects of care are needed. Methods: We convened a 9-member, multidisciplinary expert panel and used RAND/UCLA modified Delphi methods to develop palliative care quality indicators for patients with cirrhosis. Experts were provided with a report based on a systematic review of the literature that contained evidence concerning the proposed candidate QIs. Panelists rated QIs prior to a planned meeting using a standard 9-point RAND appropriateness scale. These ratings guided discussion during a day-long phone conference meeting, and final ratings were then provided by panel members. Final QI scores were computed and QIs with a final median score of greater than or equal to 7, and no disagreement was included in the final set. Results: Among 28 candidate QIs, the panel rated 19 as valid measures of quality care. These 19 quality indicators cover care related to information and care planning (13) and supportive care (6). Conclusions: These QIs are evidence-based process measures of care that may be useful to improve the quality of palliative care. Research is needed to better understand the quality of palliative care provided to patients with cirrhosis.

AB - Background and Aims: There are guidelines for the medical management of cirrhosis and associated quality indicators (QIs), but QIs focusing on standards for palliative aspects of care are needed. Methods: We convened a 9-member, multidisciplinary expert panel and used RAND/UCLA modified Delphi methods to develop palliative care quality indicators for patients with cirrhosis. Experts were provided with a report based on a systematic review of the literature that contained evidence concerning the proposed candidate QIs. Panelists rated QIs prior to a planned meeting using a standard 9-point RAND appropriateness scale. These ratings guided discussion during a day-long phone conference meeting, and final ratings were then provided by panel members. Final QI scores were computed and QIs with a final median score of greater than or equal to 7, and no disagreement was included in the final set. Results: Among 28 candidate QIs, the panel rated 19 as valid measures of quality care. These 19 quality indicators cover care related to information and care planning (13) and supportive care (6). Conclusions: These QIs are evidence-based process measures of care that may be useful to improve the quality of palliative care. Research is needed to better understand the quality of palliative care provided to patients with cirrhosis.

KW - End-stage liver disease

KW - Palliative care

KW - Quality

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Palliative Care Quality Indicators for Patients with End-Stage Liver Disease Due to Cirrhosis

Abstract

Keywords

ASJC Scopus subject areas

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