BMJ Support Palliat Care 3:174-180 doi:10.1136/bmjspcare-2012-000390
  • Research

Quality indicators for palliative and end of life care: a review of Swedish policy documents

  1. Carl Johan Fürst5,6
  1. 1Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden
  2. 2Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Radiation Sciences, University of Umeå, Umeå, Sweden
  4. 4FoU unit, Östersunds Hospital, Östersund, Sweden
  5. 5Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden
  6. 6Department of Clinical Sciences, Lund University, Lund, Sweden
  1. Correspondence to S Lind, Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm S 100 61, Sweden; susanne.lind{at}


Background All patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.

Methods We reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.

Results We found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and ‘The care and nursing of the elderly’. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.

Conclusions In the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.

  • Received 16 October 2012.
  • Revision received 2 February 2013.
  • Accepted 8 February 2013.
  • Published Online First 6 March 2013

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