PCOCI Aim & Objectives

The Palliative Care Outcomes Collaboration Ireland (PCOCI) Quality Improvement Programme aims to optimise the quality of palliative care by embedding the use of evidence based clinical assessment tools with an assessment and response framework in clinical practice. The tools are used to evaluate the symptoms, functional performance and clinical status of patients and families (in the context of palliative care, the family is defined as any person who is significant to the patient (1)) and monitor the outcomes of care for people with life-limiting illnesses, for the purpose of improving comfort, dignity, and quality of life.  

PCOCI Objectives

The objectives of the Palliative Care Outcomes Collaboration Ireland (PCOCI) Quality Improvement Programme are aligned to expert recommendations on outcome measurement in palliative care in clinical practice (2,3). The Organisation for Economic Co-operation and Development’s (OECD’s) Best-Practice Public Health Framework (4) criteria for selection of interventions focuses on effectiveness (Are the intervention’s objectives achieved?), efficiency (Are resources used well relative to outcomes?)  Equity (Does it reduce or avoid increasing health inequalities?), evidence based (How strong and valid is the evidence supporting the intervention?) and extent of coverage (How much of the target population does the intervention reach?). The OECD framework has been used to evaluate the use of the PCOC assessment and response framework at a population-level over a ten-year period (5). 

The National Office for Clinical Audit (NOCA) adopts a Quality Improvement (QI)-focused approach to developing measurable aims and objectives for national audits, datasets and registries. To achieve this, NOCA integrates established quality frameworks from the Institute for Healthcare Improvement (IHI), the Institute of Medicine (IOM), and the World Health Organization (WHO), alongside the Donabedian model (6). Hence the following objectives were informed by the IOM domains of quality in healthcare and the IHI’s Quintuple aim of improving population health, enhancing patient experience of care, reducing cost per capital, advancing health equity while minimising/reducing staff burnout (7,8). Mapping the objectives against these frameworks emphasises the quality-improvement focus of the planned dataset and its objectives. Table 1 outlines the high-level objectives and the frameworks that underpin the PCOCI Quality Improvement Program. 

Table 1