Indicators of Integration of Oncology and Palliative Care Programs: An International Consensus
Menée par enquête auprès de 47 experts, cette étude internationale présente une liste d'indicateurs permettant de définir et d'évaluer l'intégration de l'oncologie et des soins palliatifs dans des programmes hospitaliers dédiés aux patients atteints d'un cancer de stade avancé
Background : Recently, the concept of integrating oncology and palliative care has gained wide professional and scientific support; however, a global consensus on what constitutes integration is unavailable. We conducted a Delphi Survey to develop a consensus list of indicators of integration of specialty palliative care and oncology programs for advanced cancer patients in hospitals with ≥100 beds.
Design : International experts on integration rated a list of indicators on integration over 3 iterative rounds under 5 categories: clinical structure, processes, outcomes, education and research. Consensus was defined a priori by an agreement of ≥70%. Major criteria (i.e. most relevant and important indicators) were subsequently identified.
Results : Among 47 experts surveyed, 46 (98%), 45 (96%) and 45 (96%) responded over the 3 rounds. 19 (40%) were female, 24 (51%) were from North America and 14 (30%) were from Europe. 16 (34%), 7 (15%) and 25 (53%) practiced palliative care, oncology and both specialties, respectively. After 3 rounds of deliberation, the panelists reached consensus on 13 major and 30 minor indicators. Major indicators included 2 related to structure (consensus 95-98%), 4 on processes (88-98%), 3 on outcomes (88-91%) and 4 on education (93-100%). The major indicators were considered to be clearly stated (9.8/10), objective (9.4/10), amenable to accurate coding (9.5/10) and applicable to their own countries (9.4/10).
Conclusions : Our international experts reached broad consensus on a list of indicators of integration, which may be used to identify centers with a high level of integration, and facilitate benchmarking, quality improvement and research.
Annals of Oncology , résumé, 2015