• Kathleen Leemans, Luc Deliens, Anneke L Francke, Robert Vander Stichele, Lieve Van den Block, and Joachim Cohen.
• End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium kleemans@vub.ac.be.
• Palliat Med. 2015 Jan 1; 29 (1): 71-82.

BackgroundIn the absence of a standardized, comprehensive and valid set of quality indicators for palliative care, we developed one for palliative care services in Belgium.AimThis study evaluates its face validity, feasibility, discriminative power and usefulness.DesignWe combined a quantitative analysis evaluating the answers with qualitative interviews with the contact persons of all participating services.SettingThe quality indicator set was implemented in nine palliative care services in Belgium involving a measurement procedure with questionnaires to the patients of the services, their professional caregivers, family carers and physicians.ResultsThe response rate was 56% for patients, 97% for caregivers, 56% for family carers and 65% for physicians, indicating good feasibility of the measurement procedure. During the interviews, caregivers found the indicator scores valid and none was extremely skewed, confirming their discriminative power. Still, 20 of the 80 indicators showed problems of feasibility and 5 of usefulness. One was discarded and the others were improved by changing either the formulation of the indicator or the questions used. Most participants expressed a desire for a smaller but still comprehensive set.ConclusionBased on the results, minor adjustments were made to individual indicators, to the measurement tools and to the procedure used; the quality indicators are now ready for further evaluation and use across palliative care services in Belgium. As soon as these indicators are being used systematically, it will be possible to demonstrate and compare quality at the national and international levels and to evaluate improvement initiatives.© The Author(s) 2014.

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