The American Academy of Hospice and Palliative Medicine (AAHPM) and the Hospice & Palliative Nurses Association (HPNA) recently published a list of performance measures to assess the quality of palliative and hospice patient care.
Refined over two years, the groups' Measuring What Matters recommendations [PDF] outline 10 clinically relevant measures to drive quality care. The list includes:
- Documenting patients’ preferences for life-sustaining treatments and their surrogate decision makers’ names;
- Screening patients for physical symptoms;
- Treating pain;
- Screening and managing dyspnea; and,
- Discussing patients' emotional and psychological needs.
"I'd say these things are relevant for hospitalists' patients, and for all seriously ill patients, whether or not a palliative care need has been identified," says Joe Rotella, MD, MBA, AAHPM's CMO and co-chair of the Measuring What Matters clinical user panel. The measures should make it possible to raise awareness about what constitutes quality of care for seriously ill patients and to compare quality between settings and between patients who receive palliative care and equally ill patients who do not, he notes.
The quality indicators, which have been reviewed by the National Quality Forum, focus on processes of providing palliative and hospice care and seek to achieve consistency in care quality among providers. For instance, do patients who screen positive for at least moderate pain receive treatments within 24 hours? Likewise, patients receiving hospice care should have a documented discussion of their spiritual concerns or of their preference not to have such a discussion, the recommendations state.
"It's worth looking at what really matters to these patients and maybe adapting a few measures for your hospital's quality improvement program," Dr. Rotella says.
Listen to our recent podcast on hospitalists and palliative care.