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Table 2 Key objectives of the national quality improvement program and associated quality indicators, measured with the CQ index palliative care

From: The effect and process evaluations of the national quality improvement programme for palliative care: the study protocol

Key objectives of the programme Quality indicators measured with CQ index version for patients Quality indicators measured with CQ index version for bereaved relatives
Patients die at their preferred place - *Percentage of patients who died in the location of their preference
*Extent to which patients in the last month before their death were in the location of their preference
Patients and relatives feel they are in control regarding palliative care *Extent to which patients experience respect for their autonomy *Extent to which relatives indicate that the patient was asked about her/his opinions with regard to end-of-life decisions
*Extent to which patients receive information from their caregivers about the expected course of the disease *Extent to which direct relatives received information about the advantages and disadvantages of various types of treatment
*Extent to which patients receive information about the advantages and disadvantages of various types of treatments *Extent to which direct relatives received information that was understandable and unambiguous at the time of the patient’s death
*Extent to which patients indicate that they receive understandable explanations *Extent to which, according to the bereaved relatives, their autonomy was respected
*Extent to which direct relatives were informed about the possibilities of aftercare
Patients and relatives see palliative care as being coordinated *Extent to which patients know who the contact person is for the care *Extent to which the bereaved relatives knew who the contact person was for the care
*Extent to which patients experience expertise of caregivers and continuity of care *Extent to which direct relatives perceived expertise of caregivers and continuity of care
*Extent to which patients receive contradictory information
Patients and relatives feel care to be concordant with their needs, preferences and values *Extent to which patients are satisfied with “politeness” and “being taken seriously” by caregivers *Extent to which the direct relatives felt that they were treated well in all respects by the caregivers
*Extent to which patients experience respect for their privacy *Extent to which direct relatives considered that the patient had the opportunity to be alone
*Extent to which patients indicate that caregivers respect their life stance *Extent to which the direct relatives had the opportunity to be alone with their relative
*Percentage of patients who receive medical aids soon enough
Patients and relatives receive care for their needs in the physical, psychosocial, and spiritual domains *Extent to which patients receive support for their physical symptoms (pain, fatigue, shortness of breath and constipation) *Extent to which relatives indicate that the patient had access to a counselor for spiritual problems
*Extent to which patients receive help with physical care *Extent to which relatives indicate that the patient received support with preparations for saying goodbye
*Extent to which patients receive attention from their caregivers *Extent to which relatives indicate that there was attention for the psychosocial and spiritual well-being of the patient
*Extent to which patients receive support when they feel anxious or feel depressed *Extent to which, according to the direct relatives, attention was paid to their own psychosocial and spiritual well-being
*Extent to which patients indicate that they have access to a counsellor for spiritual problems *Extent to which direct relatives felt supported by the caregivers immediately after the patient’s death
   *Extent to which a final conversation or discussion was held to evaluate the care and treatment