Qualitative evaluation links SPHERE-Stanford palliative care program with stronger quality-improvement capability in Australia

A qualitative evaluation of the SPHERE-Stanford Medicine Collaborative Quality Improvement Program found that clinicians at seven Australian palliative care services reported stronger quality-improvement knowledge and confidence, better identification of service problems and locally designed interventions associated with increased referrals, improved care integration and more consistent documentation. The findings, summarized in the published abstract, describe participants’ experiences and do not provide quantitative estimates of the program’s effect on clinical outcomes.

The study involved semi-structured interviews with 25 participants from seven participating teams: team leaders, team members, mentors and a service director. Teams had completed a six-month structured curriculum combining virtual workshops, a two-day in-person intensive and ongoing mentor support. Guided by the Consolidated Framework for Implementation Research, investigators used qualitative content analysis to identify determinants affecting implementation. As a qualitative evaluation with no reported comparison group, the work was designed to explore experiences and implementation mechanisms rather than estimate the magnitude or statistical significance of changes in outcomes.

According to the abstract, participants said the program helped them identify root causes of service challenges and design targeted interventions. They associated the resulting improvement work with increased palliative care referrals, enhanced care integration and more consistent documentation practices. Multidisciplinary collaboration, strong team cohesion and dedicated mentorship emerged as central facilitators. Executive sponsorship and proactive communication were also reported to promote stakeholder buy-in and support the adoption of new practices. Participants viewed the program as a catalyst for continuing quality-improvement work and identified opportunities to scale the approach and share outcomes.

The abstract also identifies several barriers: varying service models, limited resources, workforce turnover and insufficient awareness of palliative care among partnering services. These constraints indicate that the program operated in diverse organizational settings, although the abstract does not report the degree of variation in implementation or compare performance among services. The evidence is bounded by the small interview sample, reliance on reported experiences and the absence of reported quantitative service outcomes, costs, long-term follow-up or comparisons with nonparticipating services. The authors’ abstract calls for additional work on sustainability, dissemination and broader quality-improvement capacity across the palliative-care sector. Because the available source is the published abstract, the findings reported here reflect only the methods, results and limitations stated there rather than an assessment of the full article.

Subject of Research: Qualitative evaluation of a collaborative quality-improvement program in seven Australian palliative care services

Article Title: Fostering Locally Led Palliative Care Innovation: A Qualitative Evaluation of the SPHERE-Stanford Collaborative Quality Improvement Program

Article References: Disalvo, D., Giannitrapani, K., Lorenz, K., Offner, K., Roberts, S.-J., Puranam, S., Mickelsen, J., DeNatale, M., & Agar, M. (2026). Fostering Locally Led Palliative Care Innovation: A Qualitative Evaluation of the SPHERE-Stanford Collaborative Quality Improvement Program. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10824-6

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10824-6

Keywords: palliative care, quality improvement, SPHERE-Stanford, Australia, qualitative evaluation, implementation research, mentorship, care integration, clinical referrals, documentation, Fostering, Locally