A qualitative evaluation of Australian palliative care services’ participation in National Palliative Care Standards self-assessment

Abstract

Background: The National Standards Assessment Program (NSAP) is an Australian initiative for monitoring and supporting specialist palliative care services to align with Standards for providing quality palliative care for all Australians. It comprises evaluation of 13 National Palliative Care Standards and their elements with the purpose of identifying priority areas to focus improvement activities; strategies include peer mentor visits (PMVs) and use of evidence-based resources. Monitoring of participants’ organizational quality is structured into the program. Aim: To explore the experiences of individual services participating in the Australian National Palliative Care Standards Assessment Program. Design: Case study evaluation. Data sources: Ten case studies from participating services; service self-assessment data; peer mentor reports; in-depth interviews. Analysis: Time point comparison; thematic analysis of interview data. Results: A key strength of NSAP was the cycle between data collection, identification of key improvement areas, and development of strategies for improvement. An understanding of NSAP as a continuous quality improvement process and the potential for the integration of other national programs were noted as key service improvement strategies. The use of resources to promote best practice largely relied upon access to the Internet. PMVs were considered successful, contingent on careful matching of mentors to services. The presence of a ‘champion’ within services was perceived as a success factor. Conclusions: This evaluation informs service improvement in specialist palliative care services through the alignment of continuous quality improvement with National Palliative Care Standards. This may assist development and ongoing revision of continuous quality improvement in the international context.