Assessment of a Hospital Palliative Care Unit (HPCU) for Cancer Patients; A Conceptual Framework.

Mohammad Reza Rouhollahi, Masoud Saghafinia, Kazem Zandehdel, Ali Ghanbari Motlagh, Ali Kazemian, Mohammad Ali Mohagheghi, Mamak Tahmasebi
Author Information
  1. Mohammad Reza Rouhollahi: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
  2. Masoud Saghafinia: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran ; Department of Anesthesiology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
  3. Kazem Zandehdel: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
  4. Ali Ghanbari Motlagh: Department of Radiotherapy, Shahid Baheshti University of Medical Sciences, Tehran, Iran.
  5. Ali Kazemian: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
  6. Mohammad Ali Mohagheghi: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
  7. Mamak Tahmasebi: Cancer Research Center (Secretariat of National Cancer Research Network), Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

INTRODUCTION: The first hospital palliative care unit (HPCU) in Iran (FARS-HPCU) has been established in 2008 in the Cancer Institute, which is the largest referral cancer center in the country. We attempted to assess the performance of the HPCU based on a comprehensive conceptual framework. The main aim of this study was to develop a conceptual framework for assessment of the HPCU performances through designing a value chain in line with the goals and the main processes (core and support).
MATERIALS AND METHODS: We collected data from a variety of sources, including international guidelines, international best practices, and expert opinions in the country and compared them with national policies and priorities. We also took into consideration the trend of the HPCU development in the Cancer Institute of Iran. Through benchmarking the gap area with the performance standards, some recommendations for better outcome are proposed.
RESULTS: The framework for performance assessment consisted of 154 process indicators (PIs), based on which the main stakeholders of the HPCU (including staff, patients, and families) offered their scoring. The outcome revealed the state of the processes as well as the gaps.
CONCLUSION: Despite a significant improvement in many processes and indicators, more development in the comprehensive and integrative aspects of FARS-HPCU performance is required. Consideration of all supportive and palliative requirements of the patients through interdisciplinary and collaborative approaches is recommended.

Keywords

References

  1. J Clin Oncol. 2008 Aug 10;26(23):3824-31 [PMID: 18688048]
  2. JAMA. 2010 Mar 17;303(11):1054-61 [PMID: 20233823]
  3. CA Cancer J Clin. 2013 Sep;63(5):349-63 [PMID: 23856954]
  4. Am J Hosp Palliat Care. 2011 Sep;28(6):398-402 [PMID: 21262760]
  5. J Soc Work End Life Palliat Care. 2011;7(1):83-98 [PMID: 21391079]
  6. J Palliat Med. 2010 Mar;13(3):261-5 [PMID: 20078210]
  7. J Palliat Med. 2010 Dec;13(12):1451-9 [PMID: 21155640]
  8. N Engl J Med. 2010 Aug 19;363(8):733-42 [PMID: 20818875]
  9. Indian J Palliat Care. 2011 Jan;17(Suppl):S74-6 [PMID: 21811377]
  10. N Engl J Med. 2009 Jul 9;361(2):109-12 [PMID: 19494209]
  11. Br J Hosp Med. 1992 Sep 2-15;48(5):250-3 [PMID: 1382776]
  12. N Engl J Med. 2010 Apr 1;362(13):1211-8 [PMID: 20357283]
  13. Clin J Oncol Nurs. 2008 Jun;12(3):501-6 [PMID: 18515249]
  14. BMC Palliat Care. 2013 Aug 14;12(1):31 [PMID: 23941694]
  15. J Clin Ethics. 2009 Summer;20(2):192-200 [PMID: 19554828]
  16. J Clin Oncol. 2004 May 15;22(10):2008-14 [PMID: 15143094]

Word Cloud

Created with Highcharts 10.0.0HPCUperformanceCancerframeworkpalliativecaremainassessmentprocessesunitIranFARS-HPCUInstitutecountrybasedcomprehensiveconceptualchainincludinginternationaldevelopmentoutcomeindicatorspatientsHospitalPalliativeConceptualINTRODUCTION:firsthospitalestablished2008largestreferralcancercenterattemptedassessaimstudydevelopperformancesdesigningvaluelinegoalscoresupportMATERIALSANDMETHODS:collecteddatavarietysourcesguidelinesbestpracticesexpertopinionscomparednationalpoliciesprioritiesalsotookconsiderationtrendbenchmarkinggapareastandardsrecommendationsbetterproposedRESULTS:consisted154processPIsstakeholdersstafffamiliesofferedscoringrevealedstatewellgapsCONCLUSION:DespitesignificantimprovementmanyintegrativeaspectsrequiredConsiderationsupportiverequirementsinterdisciplinarycollaborativeapproachesrecommendedAssessmentCareUnitPatientsFrameworkValue

Similar Articles

Cited By