Evaluación cualitativa del desarrollo del Proyecto Demostrativo OMS de Cuidados Paliativos de Cataluña a los 15 años de su implementación y propuestas de mejora del programa / Qualitative evaluation and suggestions for improvement of the WHO Palliative Care Demonstration Programme in Catalonia at 15 years after implementation

Introduction: quality assessment should be considered equally relevant and a complement of the quantitative aspects usually described in the evaluation of public palliative care programmes. Objectives: a) to describe the results of the qualitative evaluation of the WHO Palliative Care Demonstration Programme in Catalonia at 15 years after its implementation; b) to describe quality improvement strategies for public palliative care programmes. Material and method: elements of the EFQM methodology were applied. Palliative care leaders and experts on service organization got together to review and qualitatively assess eight dimensions, including coverage, access and equity, quality of services, links amongst health sectors, professionals, training, research, and funding. Results: the following strengths were identified: good coverage for cancer patients, although less developed for patients affected with other diseases; professional expertise, diverse backgrounds and commitment; the generation of scientific evidence in effectiveness and efficacy; high satisfaction perceived in patients and families. There were several areas for improvement, such as coverage for non-cancer patients; on-call duties; equity amongst health sectors; variability on the implementation of general measures in conventional services; poor development of psychosocial care and quality improvement policies; poor support mechanisms; poor professional and academic recognition, and mechanisms of funding poorly adapted to the complexity of services. Conclusions: the Catalan palliative care programme has demonstrated its capacity to respond well to the needs of the population at 15 years after its implementation. It should, however, be dynamic and able to accept changes in response to the growth and maturity of its professionals.