The literature and evidence relating to palliative care has expanded rapidly. [1] There is also an increasing policy focus on the delivery of palliative care given an ageing population and the number of people living with advanced and progressive illnesses. [2] While these factors support the need for change, a more deliberative approach is needed to progress these changes.
The National Institute of Clinical Studies (NICS) has indicated that the first step is to identify where there are gaps between what is known and what is done. [3] Major evidence sources for palliative care include:
- Lorenz K, Lynn J, Morton SC, Dy S, Mularski R, Shugarman L, et al. End-of-Life care and outcomes. Rockville (MD): Agency for Healthcare Research and Quality (US); 2004 Dec. Evidence Report / Technology Assessment Number 110
- Clayton J, Hancock K, Butow P, Tattersall M, Currow D. Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. Med J Aust. 2007; 186(12 Suppl):S77-S108
- Visit palliAGED for evidence-based guidance.
Such sources can be used to determine clinical and service standards based on research evidence. Further evidence on specific palliative care topics can be found in the CareSearch Review Collection.
Audit and benchmarking activities in addition to more formal research studies can highlight gaps between practice and evidence or variations across sites or services. Many palliative care services carry out audit activities as part of their ongoing management processes. The Palliative Care Outcomes Collaborative (PCOC) provides another mechanism for services to assess their performance against other services using validated data collection instruments. These data sources can be used to compare performance against the research evidence and to identify any gaps that may need to be investigated.