Improving lives of cancer and dementia patients

Palliative care focuses on relieving disease symptoms and preventing the suffering of patients. The IMPACT (Implementation of quality indicators in palliative care study) project has identified particular strategies and factors to enhance the effectiveness of palliative care.

An analytic framework to characterise models of palliative care for both patient groups (patients with severe dementia and patients with progressive cancer) has been developed. As it applies across Europe, several qualitative research methods have helped with its production.

Several peer-reviewed scientific papers have described the variation in European healthcare systems and delivery patterns with regard to the national context. Other variables include the available workforce as well as the settings and professionals available.

Team members also looked into specific barriers to and facilitators of the anticipated use of these indicators. They developed a web-based system to register feedback from the organisations' assessments.

Successful strategies to improve the organisation of palliative care were identified from a study of relevant literature. A method for analysis of the implementation strategies used and an inventory of the factors influencing implementation of improvements in palliative care have also been developed.

With the help of a literature review and a modified RAND Delphi-procedure, experts developed a set of QIs after answering questionnaires in five rounds. Germany, Italy, the Netherlands, Norway and the United Kingdom participated in the pilot in four types of settings – hospitals, hospices, nursing homes and primary care facilities.

Other countries can now use the QIs and there is an instruction manual on how to use them, how to start improvement projects and strategies for their implementation. Data will continue to be collected for QI adjustments and to create a larger data set.

IMPACT and EURO-IMPACT consortia joined forces to emphasise the need they felt to involve policymakers and influence the political agenda towards the implementation of policy recommendations by 2020. A declaration derived from policy recommendations has been signed by policymakers and the European Association for Palliative Care (EAPC). Available on the project website, the document has been translated into six other languages and stands to ensure high-quality palliative care in an ageing society in Europe (and beyond).