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Recording patient preferences for end-of-life care as an incentivized quality indicator: What do general practice staff think?
- Source :
- Palliative Medicine; Jun2012, Vol. 26 Issue 4, p336-341, 6p
- Publication Year :
- 2012
-
Abstract
- Introduction: Since April 2009, indicators for the UK Quality and Outcomes Framework pilot have been developed and piloted across a nationally representative sample of practices. In October 2009 a single palliative care indicator was piloted for 6 months that looked at, ‘the percentage of patients on the palliative care register who have a preferred place to receive end-of-life care documented in the records’.Aim: The aim of this study was to gain the views and experiences of general practice staff on whether the inclusion of a single incentivized indicator to record the preferred place to receive end-of-life care would improve the quality of palliative care. Any issues arising from its implementation in a pay-for-performance scheme were also explored.Methods: Interviews took place with 57 members of staff in 24 practices: 21 GPs, 16 practice managers, 12 nurses and eight others (mostly information technology experts).Results: The indicator was not deemed appropriate for incentivization due to concerns about incentivizing an isolated, single issue within a multi-faceted, multi-disciplinary and complex topic. Palliative care was seen to be too sensitive and patient specific to be amenable to population-level quality measurement. In implementation, the indicator would pose potential harm to patients who may be asked about their end-of-life care at an inappropriate time and by a member of staff who may not be best placed to address this sensitive topic.Conclusions: The most appropriate time to ask a patient about end-of-life care is subjective and patient specific and therefore does not lend itself to an inflexible single indicator. Focusing on one isolated question simplifies and distracts from a multi-faceted and complex issue and may lead to patient harm. [ABSTRACT FROM PUBLISHER]
Details
- Language :
- English
- ISSN :
- 02692163
- Volume :
- 26
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Palliative Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 76331953
- Full Text :
- https://doi.org/10.1177/0269216311406990