Article Text

Download PDFPDF
Quality for home palliative care: an Italian metropolitan multicentre JCI-certified model
  1. Franco Rizzi1,
  2. Massimo Pizzuto1,
  3. Laura Lodetti2,
  4. Oscar Corli3,
  5. Daria Da Col4,
  6. Maria Eugenia Damiani5,
  7. Dorian Mihali6,
  8. Laura Piva7,
  9. Luigi Saita8,
  10. Maria Vinci9,
  11. Antonio Bonaldi1,
  12. Milan Palliative Care Group Investigators
  1. 1Istituti Clinici di Perfezionamento Hospital, Milan, Italy
  2. 2Progea Consulting, Milan, Italy
  3. 3Center for the Evaluation and Research on Pain, Mario Negri Institute for Pharmacological Research, Milan, Italy
  4. 4Niguarda Cà Granda Hospital, Milan, Italy
  5. 5L Sacco Hospital, Milan, Italy
  6. 6Fatebenefratelli and Opthalmic Hospital, Milan, Italy
  7. 7San Paolo Hospital, Milan, Italy
  8. 8Fondazione IRCCS lstituto Nazionale Tumori, Milan, Italy
  9. 9San Carlo Borromeo Hospital, Milan, Italy
  1. Correspondence to Dr Franco Rizzi, Istituti Clinici di Perfezionamento Hospital, via Castelvetro 28, Milan 20155, Italy; franco.rizzi{at}


Background Assessing the quality of care and service delivery through the analysis of ad hoc indicators is a relevant process for quality monitoring and improvement with a view to providing patients, the community and administrators alike with appropriate elements of evaluation. This paper describes the key results of a certification process based on the Joint Commission International (JCI) criteria for the home hospitalisation model implemented by the palliative care units of seven Milan hospitals for terminally ill patients with cancer.

Methods In 2006, the interhospital working team implemented a certification project based on the JCI Disease or Condition-Specific Care (DSCS) programme. Thirty standards subdivided into five functional areas with 150 measurable elements were the starting-point for periodic improvement plans within and across participating hospitals. Programme compliance was analysed in terms of annual performance improvement and consistency across the seven PCUs involved in achieving set goals. The JCI standards were applied on 3316 terminally ill patients with cancer treated at home from 2005 to 2009.

Results As a result of the work carried out, the JCI survey conducted 3 years after project implementation demonstrated full compliance with the established standards, leading to the JCI certification award (for the first time in this clinical setting internationally).

Conclusion The work carried out with a view to certification has confirmed the possibility that facilities spread across different hospitals can actually share common processes and standardise the activities for the care of end-of-life patients with cancer at home as if they were one single service provider.

  • Palliative care quality
  • terminal cancer patient
  • JCI certification
  • healthcare quality
  • healthcare quality improvement
  • quality of care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.