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.

QAPI, palliative care, home care, risk management

Alizadeh, Z., Rohani, C., Rassouli, M., Ilkhani, M., & Hazrati, M. (2024). Bridging the gap and developing a home-based palliative care model for cancer patients. Asia-Pacific Journal of Oncology Nursing, 11(11), 100583. https://doi.org/10.1016/j.apjon.2024.100583

Anghel, I., Cioara, T., Bevilacqua, R., Barbarossa, F., Grimstad, T., Hellman, R., Solberg, A., Boye, L. T., Anchidin, O., Nemes, A., & Gabrielsen, C. (2025). New care pathways for supporting transitional care from hospitals to home using AI and personalized digital assistance. arXiv. https://doi.org/10.48550/arXiv.2504.13877

Carpenter, J. G., Lam, K., Ritter, A. Z., & Ersek, M. (2020). A systematic review of nursing home palliative care interventions: Characteristics and outcomes. Journal of the American Medical Directors Association, 21(5), 583–596.e2. https://doi.org/10.1016/j.jamda.2019.11.015

Elshehaly, M., Randell, R., Brehmer, M., McVey, L., Alvarado, N., Gale, C. P., & Ruddle, R. A. (2020). QualDash: Adaptable generation of visualisation dashboards for healthcare quality improvement. arXiv. https://doi.org/10.48550/arXiv.2009.03002

Haneuse, S., Schrag, D., Dominici, F., Normand, S.-L., & Lee, K. H. (2021). Measuring performance for end-of-life care. arXiv. https://doi.org/10.48550/arXiv.2105.08776

Kan, Y., Xiao, Y., Li, Z., Chen, Z., & Yue, P. (2025). Quality indicators for home-based palliative care: A systematic review. Journal of Pain and Symptom Management. Advance online publication. https://doi.org/10.1016/j.jpainsymman.2025.06.011

Liu, X., Liu, H., Ying, W., Zhang, Y., Gong, X., & Huang, J. (2025). Identifying palliative home care needs of patients with advanced cancer: A cross-sectional study. Frontiers in Psychiatry, 16. https://doi.org/10.3389/fpsyt.2025.1448973

Quigley, D. D., & McCleskey, S. G. (2021). Improving care experiences for patients and caregivers at end of life: A systematic review. American Journal of Hospice and Palliative Medicine®, 38(1), 84–93. https://doi.org/10.1177/1049909120931468

Shalom, E., Goldstein, A., Wais, R., Slivanova, M., Melamed Cohen, N., & Shahar, Y. (2024). Implementation and evaluation of a system for assessment of the quality of long-term management of patients at a geriatric hospital. Journal of Biomedical Informatics, 156, 104686. https://doi.org/10.1016/j.jbi.2024.104686

Toles, M., Colón-Emeric, C., Moreton, E., Frey, L., & Leeman, J. (2021). Quality improvement studies in nursing homes: A scoping review. BMC Health Services Research, 21(1), 803. https://doi.org/10.1186/s12913-021-06803-8