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From the inception of the hospice movement, research has been identified as essential to the delivery of high quality palliative and end-of-life care. Despite delivering compassionate care and excellent symptom management, research has not been embedded in hospice care. Recognising the need for greater engagement in research, our organisation first piloted the Research Lead programme in 2011. The aim was to facilitate participant involvement in palliative care studies, to facilitate evidence based practice, and to create a culture of enquiry.Full time Research Leads were appointed at three hospices in England, Scotland and Northern Ireland. A 2013 evaluation identified the benefits of such relationship-based, proactive roles. These included increased participation of patients, staff and carers in research, and enhanced research support and mentoring to all professional groups. This positive outcome contributed to programme expansion, with our organisation now employing five hospice-based research leads, each developing collaborations with regional academic institutions.Outcomes associated with increased investment in research staff at hospices are both tangible and intangible. Tangible outcomes include numbers of participants recruited for research studies, and traditional academic outputs: publications and research grants involving hospice staff, students supervised and conference presentations. Other outcomes, relate to impact and include press releases; blogs and newspaper articles based on research findings as well as contributions to local, regional and national policy, and increased staff awareness, which is crucial to an enquiring workforce.Models of hospice research engagement are still in their infancy and need to be developed and evaluated. While the primary goal of hospices is to provide excellent, patient-centred physical, social, psychological and spiritual care to patients and families, we suggest that hospices should also consider the vital role they contribute to developing evidence based care of the future.

Palliative care must change, grow and mature in response to the growing number and complexity of needs of community patients. Such demands particularly challenge conventional delivery of day hospice. In response our hospice redesigned day service provision to modernise bespoke day facilities, appoint a day hospice sister and introduce several novel clinical interventions. Patient outcome measures were introduced and research projects undertaken.The aim of the study was to evaluate whether extended day hospice services could address more patient needs. Newly developed services were introduced in the period April 2015 – May 2016. Management and clinical key performance indicators were obtained for this period and compared with annual data from the previous year. Two facilitated focus groups were undertaken with the multidisciplinary team and with the management team to better understand the service developments and participant’s aspirations for day services.It was found that introducing five additional patient services – Blood transfusion clinic; Progressive Supranuclear Palsy support group; Motor Neurone Disease clinic; Multi System Atrophy support group and a Carers’ support group – led to a 27% increase in attendances. Staff, patients and their families were recruited to three research projects by three hospice staff as a core part of their role, and five staff contributed to qualitative studies or data collection. The qualitative data indicated that staff were pioneering the new well-coordinated services but were challenged by the time available to capture data. The management team had a vision for further expansion of sustainable services and innovative approaches of working in partnership with the local acute trust and community care providers.In conclusion, a diversification of day services offered to patients and carers can be facilitated with engaged managerial and professional staff without a significant increase in core workforce.

IntroductionQuality indicators are explicitly defined and measurable items that evaluate and describe healthcare (Campbell, 2002). They can provide care users, staff, providers, and purchasers with feedback in relation to the quality of care, sometimes against benchmarks or previous quality assessments. In addition, by providing a valid and reliable means of measuring quality of care, quality indicators (although not sufficient by themselves) can act as a starting point for quality improvement. There are currently no quality indicators designed to assess the quality of palliative day services (PDS).AimTo develop a set of quality indicators to appraise the care provided by PDS in the UK.MethodsThe RAND/UCLA appropriateness method was utilised. This multi-stage method combines best available evidence alongside expert consensus. The resultant draft set of indicators was tested for feasibility in 5 UK hospices. A parallel strategy of stakeholder engagement was implemented throughout the research lifecycle.ResultsThe initial list of 185 candidate indicators identified by a systematic review was reduced to a final list of 30 core indicators, which were found to be appropriate and feasible.ConclusionsThis quality indicator set is the first to be produced for PDS, and is available for use by services. It represents a valuable, acceptable and feasible means to assess quality of care in PDS, and a means of identifying goals for quality improvement. Successful implementation of quality indicators in routine practice requires attention to a range of key enablers and barriers.Reference. Campbell, S M. (2002) ‘Research Methods Used In Developing And Applying Quality Indicators In Primary Care’. Quality and Safety in Health Care,11(4), pp. 358–364