Establishing a common definition for care provided by hospice societies in British Columbia, Canada: a Delphi process

Background: Currently, there are over 70 hospice societies spread across urban, rural, and remote communities in BC. However, these societies are not utilized to their fullest potential, primarily due to a lack of awareness of the unique role they play in their communities and common misconceptions about the types of care they provide.Objectives: To develop a consensus-based definition of the care provided by hospice societies in BC, suitable for use across government, healthcare, community organizations, and the public.Design: A modified Delphi approach, guided by an environmental scan, was used to reach consensus on a standard definition of care among a panel of experts.Methods: Following an environmental scan of gray and published literature for attributes and components of care delivered by hospice societies, the expert panel participated in a modified Delphi process of iterative surveys asking questions about content, wording, and structure of the definition. The 56-member panel consisted of hospice society experts, palliative care experts, and people with lived experience. Consensus was defined as 75% agreement across the entire panel (all) and 75% agreement across hospice society representatives (hospice).Results: After six survey rounds, consensus was met on a common definition with three different length versions: full- and medium-length versions (85% all, 85% hospice) and a short version (94% all, 100% hospice). Differing opinions within our expert panel about components of care supported the need for this common definition.Conclusion: Our consensus-based definition provides unprecedented clarity and a shared understanding about the care provided by hospice societies in BC. Hospice societies are expected to benefit from this clarity by maximizing their use and access. It is also expected that this definition will guide advocacy efforts, ultimately contributing to the quality and sustainability of hospice care across the province.