Table 1 Overview of the wording of the original IMPACT structural indicators for palliative care and adjustments made in the PACE questionnaire

1. Access to palliative care

1. Availability of and access to palliative care

 1. A specialist palliative care team is available 24/7.

Is there a specialist palliative care team present in your facility (employed in your facility)?

If yes, do you use this specialist palliative care team?

 2. Specialist palliative care advice is available 24/7 to professionals delivering palliative care.

Is specialist palliative care advice available to professionals delivering palliative care in your facility?

If yes, do you use this advice?

 3. Bereaved relatives and/or professionals involved in care of a person in need of palliative care are offered support during the bereavement process if they need or wish to have support.

Do you have a procedure in place to ensure that relatives of residents are offered bereavement support, if they need or wish to have support?

 4. Opioids are accessible and available for persons in need of palliative care 24/7.

Are opioids available 24/7 for residents in need of palliative care in your facility?

 5. Persons in need of palliative care have an assigned contact person who maintains regular contact with the person and their families and ensures coordinated delivery of health and social care.

Does your facility offer residents in need of palliative care an assigned contact person (e.g. care manager, case manager or key worker) who maintains a regular contact with the resident and his or her relatives, in order to ensure coordinated health and social care?

2. Infrastructure

2. Infrastructure for residents and families

 6. Specialized equipment (e.g. anti-decubitus mattresses, suction equipment, stoma care, oxygen delivery, drug administration pumps, hospital beds, etc.) is available to persons in need of palliative care.

What specialized equipment is available for residents in need of palliative care in your facility? (pressure relieving mattresses, suction equipment, stoma care supplies, oxygen delivery, syringe driver, hospital beds)

 7. Single bedrooms are available for persons who are dying and who wish to have one.

Are single bedrooms available in your facility for ALL residents who are dying and who wish to have one?

 8. Family members and friends are able to visit the dying person without restrictions of visiting hours.

Are there unrestricted visiting hours for relatives of residents who are dying, if they wish?

 9. There are facilities for relatives to stay overnight with their dying relative.

Are there facilities for relatives to stay overnight with their dying relative?

3. Personnel

3. Multidisciplinary meetings

 10. The multidisciplinary team that delivers palliative care services consists of at least:

a) a physician and nurse;

Is there a regular multidisciplinary meeting (with at least a physician and a nurse) to review treatment and care plans organized in your facility?

 11. There is a weekly multidisciplinary meeting with at least the physician and nurse in charge of the person in need of palliative care to review treatment and care plans.

If yes, how frequently is this meeting organized? (weekly, monthly, other frequency)

4. Quality

4. Quality improvement initiatives

 12. Family and caregiver experiences of the palliative care service are assessed/evaluated/recorded.

Does your facility systematically assess the experiences of relatives of residents regarding provided care?

 13. An end-of-life care pathway (such as the Liverpool Care Pathway) was used for the last 3 days of life of a person in need of palliative care.

Are specific guidelines used for the last 3 days of life of a resident in need of palliative care in your facility?