The project “Setting up a national evaluation system of palliative care services addressed to vulnerable groups” develops, tests, analyzes and promotes two methodologies for evaluating the quality of the palliative care services: in-patient units and home care services through a large consultative process with interested factors (authorities, public institutions, providers and beneficiaries of palliative care services)
Standards, costs, protocols
Quality Standards for Palliative Care is the starting point in achieving the quality assessment methodologies of the palliative care services It was initiated by Hospice Casa Sperantei in 2002 and revised through an extensive consultative process with experts from public and non-governmental field in 2010. The standardization process was completed with Assessment of the costs of the palliative care services in Romania and through Clinical Protocols for palliative care in 2011 (revised in 2014).
Developing, adjusting and pre-testing the methodologies for assessing the quality of palliative care: December 2015 - February 2016
30 – 31 July 2015, Brasov: first meeting of the project team
Agenda: presentation of the project and principles; reviewing the assessment grids for home care services and in-patient units; establishing the list of mandatory and additional assessment tools, procedure for the appointment the evaluation committees; set up the next steps in the project.
Participants: representatives of Hospice Casa Sperantei Brasov and Bucharest, together with representatives of the Regional Institute of Oncology Iasi, the Municipal Hospital Campia Turzii and other providers of palliative care services from Oradea (Hospice Emanuel) and Constanta (Hospice Casa Soarelui) – members of the National Association of Palliative Care.
7 – 8 October 2015, Tg Mures: working meeting „Drawing up the methodologies for assessing the palliative care providers”
The assessment grids for palliative care in in-patient units and home care services were re-analyzed, their completion being a hard and a long standing process. The assessment tools were analyzed and adjusted. It was also re-assessed the procedure for the appointment of the evaluation committee and the stages of the evaluation process.
8- 10 October 2015, Tg Mures: presentation of the project within the National Conference of Palliative Care (press conference and workshop)
During the press conference and the workshop the project was presented to 18 specialists in palliative care (representatives of public and private authorities at national level) and to 10 members of the project implementation team; the result of the seminar – recommendations regarding the assessment process.
November 2015 – February 2016: pre-testing the assessment tools within Hospice Casa Sperantei Brasov
After the preliminary tests of the Patient’s File used for palliative care in in-patient units and home care units, a meeting of the project team with the clinicians of the hospice took place in 18 February 2016. Following this meeting, the Patient’s File used for palliative care was adjusted according to the clinicians requests, appeared from the practice.
Training programm for the preparation of the assessment process: 19- 20 February; 3-5 March 2016
Training of the assessors: 19-20 February 2016, Brasov
During the two days of training, were established: the strategy of palliative care services provided in in-patient units and at home care; the evaluation committees; the calendar of the evaluation visits to be conducted in Brasov, Bucharest, Oradea, Iasi, Campia Turzii and Constanta.
Training of the representatives of the 5 palliative care providers to be evaluated: 4-5 march 2016, Brasov
Agenda of the two-days training: introduction of participants and project presentation; activities to be carried out during the preparation period, activities during evaluation visit, post-visit; the evaluation report.
Voluntary accreditation of 5 palliative care suppliers from public and non-governmental systems
Planning the evaluation visits: 28 March – 14 April 2016
28-29 March – Casa Soarelui Constanta; assessors: Camelia Nedelcu, Nicoleta Mitrea
28-29 March – Oncological Institute Iasi; assessors: Marinela Murg, Sorina Pop
04-05 April – Municipal Hospital Campia Turzii; assessors: Elena Moldoveanu –, Cristina Ghiran
04-06 April – Emanuel Foundation Oradea; assessors: Anton Diaconu, Dan Malciolu
11-14 April – Hospice Casa Sperantei Foundation Brasov; assessors Angelica Lascu, Cristina Anastasiu, Florentina Curpas
11-14 April – Hospice Casa Sperantei Foundation Bucharest; assessors Vladimir Poroch, Anca Silvestean
Project results: Evaluation Guide, Assesors
The project has the following results:
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No of methodologies, instruments, procedures, action plans, local development plans a.s.o that includes anti-discriminatory measures, inclusive values and practices, to promote equal opportunities for disadvantaged groups: 9, instead of 2 proposed (450%)
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No of participants at training sessions, conferences: 207 instead of 80 proposed (258.75%)
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Training evaluators: 12 instead of 7 proposed (171.42%)
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No of palliative care services evaluated: 8 instead of 5 proposed (160%)
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Training personnel in applying the methodologies: 85 persons instead of 80 proposed (106.25%)
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Training materials: 2 (100%)
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Authorities’’ representatives involved in project’s activities: 11 persons instead of 10 proposed (110%)
ACCREDITATION STEPS
Pre-visit (3-6 month preparing): on-line application for suppliers; Evaluation visit (2-4 days, depending on services number to be accredited ); Pos-visit: commission’s report, service’s accreditation
ELIGIBLE SERVICES FOR ACREDITATION
Can be accredited In-patients and Home Care palliative care services, self standing units or part of a complex unit. Those services can be part of public or private health system and fulfill a set of conditions. See the Evaluation Guide_Romanian version.
ASSESSORS
At the moment in Romania there are 15 assessors for palliative care services. This assessors have piloted the evaluation system during March-April 2016 on 8 palliative care services (5 suppliers). See the Romanian Assessors’ list.
Press conference(14th of April 2016, Brasov): On the occasion of its 24th Anniversary, Hospice Casa Sperantei – who support patients with progressive incurable diseases and their families – invites the citizens from Brasov to find out about our projects. Media Report
Press conferente (19th of May 2016, Bucharest): Hospice Casa Sperantei announces the launching of a new system of rising the palliative care services’ quality in Romania. The Foundation propose to National Authority of Quality Management in Health that since 2017 to include the hospitals’ system of accreditation, palliative care suppliers’ evaluation based on specific standards and instruments. The instruments and standards were created on a frame of a project financially supported by Norway, Iceland and Liechtenstein, with Regional Institute of Oncology from Iasi and Municipal Hospital from Campia Turzii as partners. Media Report
The project “Setting up a national evaluation system of palliative care services addressed to vulnerable groups” (project value: 582.321 lei) was conducted during 8th of June2015 to 31st of May 2016 by Hospice Casa Sperantei, in partnership with Regional Institute of Oncology from Iasi and Municipal Hospital from Campia Turzii and was financed with the support of RO10 – CORAI Programme, programme finaced by SEE 2009-2014 Grants and run by Romanian Social Development Fund (project coordinator Malina Dumitrescu)
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