Quality Measures for Community-Based, Rural Palliative Care Programs in Minnesota: A Pilot Study.

Abstract

Despite the growth of palliative care programs in many urban areas, palliative care programs remain less common in rural communities. As more community-based programs emerge, particularly in rural areas, it will be important to establish a standard set of quality measures that are useful for improving care and feasible for program evaluation. The study's objective was to identify and field test a standard set of quality measures for rural, community-based palliative care programs that reflect clinical quality, patient and family experience, and impact on inpatient and emergency department utilization. A pilot program was conducted to test standardized quality measures for rural, community-based programs. Measures were identified through review of existing measures and input from experts in palliative care and rural health services. The study was carried out in 2012 and 2013 in five community-based palliative care programs from rural communities. A total of 138 palliative care patients were included. Measurements were chart abstraction, patient and family experience surveys, patient-level health care utilization, and program-level operations surveys. Phone interviews with each participating program were performed at the study's end. The participating programs found the measures feasible to collect, and the information they provided aided in assessment, comparison of structure, and process improvement for care delivery. Program staff suggested additional potential measures and expressed their desire to track the measures beyond the pilot time frame. The standard measures developed and tested were deemed feasible to collect and useful for all five participating rural, community-based palliative care programs.