Organizational standards for specialized palliative care for adult patients - recommendations of the Expert Group of national consultants in palliative medicine and palliative care nursing

Introduction: The aim of the study was to develop organizational standards for specialist palliative care for adult patients (SOSOPPD) in Poland. Methods: National consultants in the field of palliative medicine and palliative care nursing established an Expert Group for the development of the SOSOPPD, which included 3 physicians - independent researchers, 2 nurses and a lawyer. The development was carried out in three stages. 1. Analysis of literature (SCOPUS and PubMed databases) and legal acts concerning palliative care. 2. Development of a questionnaire using Google Forms and Delphi survey of 120 respondents in two rounds. 3. Analysis of the results obtained by members of the Expert Group during remote meetings and determination of the final version of the SOSOPPD. Results: In the first round of the study, 71 (59.17%) participated, in the second round 56 (46.67%) invited respondents. In the first round, 73 positive (criterion of at least 70%) answers to 97 questions were obtained, in the second round 21 positive answers to 31 questions. In the scope of the remaining 10 questions, the obtained results were discussed, adopting the criterion of at least 50% positive answers. After analyzing the results of both rounds, the final version of the document was accepted by all members of the Expert Group. Conclusions: Two types (levels) of palliative care were distinguished: elements of palliative care and specialist palliative care. In the scope of specialist palliative care, home, stationary and outpatient care were distinguished, including all their organizational units in the guaranteed benefits. Requirements and procedures for all organizational units of specialist palliative care were described. A division into three reference levels of stationary care was introduced, taking into account the complexity of services provided to patients, pre- and postgraduate education. The principles of qualifying patients for palliative care, the development of science and education in the field of palliative medicine and palliative care nursing were presented.