• Tong Jen Lo, Neo Patricia S H PSH Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore., Tan Ying Peh, Ramaswamy Akhileswaran, Wei Ting Chen, Angel Lee, and Standards Development Subgroup of the National Strategy for Palliative Care Implementation Taskforce and Guidelines Implementation Workgroup.
• Division of Supportive and Palliative Care, National Cancer Center Singapore, Singapore.
• J Palliat Med. 2019 Nov 1; 22 (11): 1439-1444.

Abstract Background: Palliative care guidelines and quality measures have been developed in many countries to improve the quality of care. The challenge is to implement quality measures nationally to improve quality of care across all settings. Objective: This article describes the development and implementation of National Guidelines for Palliative Care (NGPC) in Singapore. Design: The NGPC was developed through literature review, multidisciplinary inputs, and modified RAND Delphi method. Quality measures for the guidelines were developed through literature review and multidisciplinary inputs and implemented with an audit of specialist palliative care providers. Results: The NGPC consisted of 13 guidelines and 64 quality measures. A total of 11 palliative care services (73.3%) participated in the audit from September 2015 to October 2015. National-level and service-level gaps in quality of care were identified and individual providers identified priority areas for improvement. Conclusion: We successfully developed the national palliative care guidelines and quality measures. We implemented voluntary self-assessment among health care institutions in various settings nationally that serve to catalyze quality improvement and cultivate a culture of quality improvement.

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