• Various computer based reminder systems for physicians or prompt in paper charts.
• Relay of clinical data transmission where patient data are transmitted to primary care physicians over telephone or fax.
• Auditing of the evidences of practices for quality improvement can be done by tracking and reviewing the performance of physicians. Quality indicators, publicly released data, reports etc can be used for better feedback.
• Organizational change including quality management or shifting from paper based to electronic of computer based tracking systems.
• Promotion of workshops or materials
• Qualitative discussion on extensive care patients between experts
• Performance based incentives, reimbursement systems for physicians and nurses, regulations etc.
Above listed changes will certainly help observing the quality improvement for palliative care or cancer patients or similar diseases. Intervention can be in form of treatment, diagnostic test, prognostic factors and procedure. Planning and procedure to treat terminal cancer patients would be an intervention. What medicines would result in better treatment can be answered based on the observations in the hospice.
Addressing the question 1, interventions detailed above are discussed and compared on the basis of evidences for effectiveness of quality improvements of healthcare systems or nursing. The second question was developed to address the comparison of various structural models of policy or change systems of healthcare; consultative models and integrative models. Integrative models include daily practice of palliative care principles and interventions while consultative models is compared on the basis of increasing use and effectiveness palliative care consultants (Nelson JE, Boss RD, et al., 2010). All the relevant interventions are categorized into these quality intervention models and thus evidences or existing clinical research reports are compared for effectiveness. Simply a developed question with respect to new therapy is compared with the existing one.