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Audit tools for palliative care services: Identification of neglected aspects of care

Centre for Primary Health Care, University of Warwick, Coventry, United Kingdom

Gary Smith

University of Birmingham, Hampton-in-Arden, Solihull, West Midlands, United Kingdom

David White, PhD

Centre for Health Psychology, Staffordshire University, Stoke-on-Trent, United Kingdom

Carol Austin, MSc

Centre for Health Psychology, School of Sciences, Staffordshire University, College Road, Stoke-on-Trent, United Kingdom

Marian Pitts, PhD

Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia

The purpose of this study was to investigate the extent to which audit of palliative care service occurs nationally in Britain and Ireland. The following items were measured: (1) audit tools employed, (2) aspects of services undergoing audit, (3) changes in practice as a result of audit, and (4) obstacles to conducting some aspects of the audit. Audit practices were surveyed by means of a postal questionnaire distributed to managers of all hospice and palliative care services in the United Kingdom and Republic of Ireland. A 10 percent sample of managers (n = 40) who responded were subsequently interviewed to confirm and elaborate on questionnaire responses. The response rate was 60 percent and was highest for hospices at 68 percent. Of the respondents, 73 percent audit their services. Of those who audit their services, 79 percent changed their service as a result. Although physical aspects of care were audited frequently (61 percent), other core aspects of palliative care that rarely were audited included bereavement care (17 percent), training (13 percent), and psychological and spiritual care (12 percent). Managers indicated that some aspects of care were rarely audited because they considered clinical and organizational aspects of palliative care to be more important. They also stated that they did not have enough time, expertise, or adequate measurement tools. Until the neglected features of palliative care are audited, the full effectiveness of the services remains unknown.

Key Words: palliative care • audit tools • hospice • spiritual care • bereavement care • psychological care

American Journal of Hospice and Palliative Medicine®, Vol. 19, No. 6, 397-402 (2002)
DOI: 10.1177/104990910201900610


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