• Mary Nevin, Sheila Payne, and Valerie Smith.
• School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland.
• Palliat Med. 2024 Sep 27: 26921632412835402692163241283540.

BackgroundHealthcare providers working in hospitals have significant exposure to patients with palliative care needs. For many patients, these needs often reflect non-specialist rather than specialist palliative care needs. Embedding a palliative care approach in acute hospital-based care however is challenging.AimTo identify core indicators for the integration of a palliative care approach in hospitals.DesignA Delphi technique used three sequential online survey rounds. Preliminary indicators were identified in a concept analysis of a palliative care approach, and a systematic review of hospital-based healthcare providers' views of a palliative care approach.ParticipantsAn international expert panel of three key stakeholder groups (clinicians, researchers, patients/family members) participated in each Delphi round.ResultsThe Delphi participants were recruited from 12 countries; 97 individuals responded to round 1, 78 to round 2 and 72 to round 3 (74% overall response rate). Consensus was achieved (defined a priori as >70%) on 32 core indicators of a hospital-based palliative care approach, with five structural indicators (relating to infrastructure and governance), 21 organisational indicators (relating to clinical care processes) and six staff indicators (relating to training and support for healthcare providers).ConclusionsThis study offers multi-level guidance for clinical practice, policy and research related to integration of a palliative care approach in hospitals, based on evidence and international consensus from major stakeholder groups. These core indicators provide a means to assess, review and communicate the core elements of a palliative care approach in hospitals.

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