Use of QAPI Methodology for Risk Management in Home Palliative Care

Аннотация

This article presents a theoretical and analytical review of the applicability of the QAPI (Quality Assurance and Performance Improvement) methodology for risk management in home-based palliative care. The study is based on an interdisciplinary approach that integrates systems theory, the Donabedian model, quality of care assessment tools, and digital monitoring algorithms. Particular attention is given to aligning structure, process, and outcome indicators with empirical data on patient needs and organizational barriers specific to outpatient settings. Sources covering patient-centered care, resource constraints, multicultural contexts, and care digitalization are analyzed. Based on regression models and content analysis of the literature, key risks are identified, including emotional burnout, informational deficits, inadequate symptom control, and insufficient spiritual support. A conceptual model for QAPI integration is proposed, which incorporates both technical and humanitarian aspects of quality. The developed framework includes indicators adapted to the context of home care, digital visualization tools, and principles for sustainable implementation under resource constraints. This article will be of interest to researchers in palliative medicine, quality management professionals, outpatient care coordinators, and all those involved in developing and implementing patient-centered systems for evaluating and improving home-based care.