Study protocol : evaluation of specialized outpatient palliative care in the German state of Hesse (ELSAH study) – work package I : assessing the quality of care

  • Background: In Germany, patients suffering from life-limiting conditions are eligible for specialized outpatient palliative care (SOPC). Evaluation of the quality of this service lacks currently integration of patient-relevant outcomes. There is also no scientific consensus how to prove quality of care in the special context of SOPC adequately. Existing quality reports are primarily based on descriptive structural data which do not allow for estimation of process quality or result quality. The ELSAH study ("Evaluation of Specialized Outpatient Palliative Care in the German state of Hesse") aims to choose - or, if necessary, to adopt - to evaluate and to implement a suit of measures to assess, evaluate and monitor the quality of specialized, home-based palliative care. Methods: All 22 SOPC teams providing their services in the state of Hesse, Germany, participate in the ELSAH study. The study is divided in two phases: a preparation phase and a main study phase. Based on the findings of the preparation phase we have chosen a preliminary set of instruments including the Integrated Palliative Outcome Scale, Views on Care, Zarit Burden Interview, Phase of Illness, Goal Attainment Scaling, Eastern Cooperative Oncology Group Performance Status, Consumer Quality Indices Palliative Care and Sense of Security in Care. During the main study phase, we will use a mixed-methods approach to evaluate the instruments’ psychometric properties (reliability, validity, feasibility and practicability), to identify barriers, facilitators and limitations of their routine use and to explore how their use affects the care within the SOPC setting. Discussion: At the end of this study, an outcome- and patient-centered, validated measurement approach should be provided, adapted for standardized evaluations in SOPC across patient groups, palliative care services and regions nationwide. The standardized application of instruments should allow for making valid statements and comparisons of health care quality in SOPC based on process- and outcome-evaluation rather than relying on structural data only. Moreover, the instruments might directly influence the care of patients in palliative situations. Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00012421).

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Author:Katrin Kuss, Hannah Seipp, Dorothée Becker, Stefan Bösner, Antje Erler, Dania Gruber, Michaela Hach, Lisa-R. Ulrich, Jörg Haasenritter
Pubmed Id:
Parent Title (English):BMC palliative care
Publisher:BioMed Central
Place of publication:London
Contributor(s):Jasmin Buller
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/10/02
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/10/11
Tag:Evaluation; Implementation; Mixed methods; Outcome assessment [MeSH]; Palliative care [MeSH]; Quality of health care [MeSH]; Study protocol; Validation
Issue:1, Art. 111
Page Number:9
First Page:1
Last Page:9
Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0