Palliative and hospice care is a growing field, but until recently there has been no way for referring physicians, hospitals, payers, patients and their families to effectively evaluate a program's quality.
The American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association consensus project, Measuring What Matters, has determined 10 key indicators of the highest quality palliative and hospice care. The findings and recommendations were published online in the Journal of Pain and Symptom Management.
Measuring What Matters determined a set of measures that are scientifically rigorous and can be used to eventually enable benchmarking in the field, according to a press release. Currently, there is no consistency regarding which measures are required by various groups, from accrediting organizations to payers.
The AAHPM and HPNA's 10 key quality indicators for palliative and hospice care are listed below:
1. Palliative care and hospice patients receive a comprehensive assessment (physical, psychological, social, spiritual and functional) soon after admission.
2. Seriously ill palliative care and hospice patients are screened for pain, shortness of breath, nausea and constipation during the admission visit.
3. Seriously ill palliative care and hospice patients who screen positive for at least moderate pain receive treatment (medication or other) within 24 hours.
4. Patients with advanced or life-threatening illness are screened for shortness of breath and, if positive to at least a moderate degree, have a plan to manage it.
5. Seriously ill palliative care and hospice patients have a documented discussion regarding emotional needs.
6. Hospice patients have a documented discussion of spiritual concerns or preference not to discuss them.
7. Seriously ill palliative care and hospice patients have documentation of the surrogate decision-maker's name (such as the person who has healthcare power of attorney) and contact information, or absence of a surrogate.
8. Seriously ill palliative care and hospice patients have documentation of their preferences for life-sustaining treatments.
9. Vulnerable elders with documented preferences to withhold or withdraw life-sustaining treatments have their preferences followed.
10. Palliative care and hospice patients or their families are asked about their experience of care using a relevant survey.