Ahead of this week’s 8th EAPC World Research Congress, plenary speaker Professor David Currow, Discipline of Palliative and Supportive Services, Flinders University, Adelaide, Australia, shares some thoughts.
Who is the next person that is going to be referred to your service? At the moment it is something of a lottery. We are not systematically approaching the patient population that we serve. The next challenge is having been referred, how are we going to value add to this person’s care? Will we be taking the role of primary care (in some places in the world this is the only choice), or are we going to support other caregivers either at a primary or tertiary level to provide that care?
Ultimately, how do we measure the quality of the care? There are a number of ways that we can approach this. One way is better using routine data collection and analysing it to look at the quality of care. Although this is difficult several research groups around the world are successfully doing this. The next is to look at the quality of care with specific data collection within specialist services. This, however, is not going to look at the quality of dying across the community.
One of the really great examples of looking at the quality of dying is the resource done by ‘The Economist’ and developed and funded by the Lien Foundation in 2010. It started the process of comparing the availability of palliative care across the world and hence palliative care’s contribution to improving care.
If we are going to look at the quality of care at the end of life we cannot just look at palliative care services. It is a great starting point for palliative care services to look critically at how they add value and where their care may be less than the high quality to which they would aspire, but we need to go beyond this. We need to look at the opportunities that have been taken by several research groups around the world that can really take us forward in thinking about what it is that we can do every day in each of our services to grow the quality of our care; then we need to measure that, and, most importantly, to grow the quality of the service that we offer in the community.
We serve an incredibly frail population (whatever their age). Fundamentally, this means that our role in looking at quality of care must include toxicities and harms, especially if they are iatrogenic. Little work to date has been done in palliative care in this space.
We are charged with a very challenging role – to provide care for people at the end of life. The quality of that care cannot only be measured in a drawer full of thank-you letters. We need to apply every lens that is currently used in the evaluation of the quality of health service delivery in order to ensure that we are really providing the best, patient-centred care that is achievable.
If you’re coming to the 8th EAPC World Research Congress in Lleida…
Professor Currow’s plenary lecture takes place at 09.00 on Friday 6 June in Auditorium 1 in the congress centre. Even if you aren’t attending in person, you can still follow us on Twitter @EAPCOnlus – our official congress hashtag is #eapc2014 And we plan to publish more news from the congress here on the EAPC Blog.