Are you providing the best care for your dying or seriously ill patients? How do you know?
To help health care providers answer those questions, the American Academy of Hospice and Palliative Medicine and the Hospice & Palliative Nurses Association have compiled a checklist of 10 quality indicators as part of their Measuring What Matters project. They were selected from 75 indicators, largely based on what’s most important to patients and their families.
Although the value of hospice and palliative care in improving the quality of life for seriously ill individuals is by now universally recognized, the sad fact is that less than half of Americans who die receive hospice care, and then often only in the waning days of their lives. “As the population ages and the demand for this type of care grows, the ability to assess quality throughout the country and across care settings is increasingly important,” project organizers said.
The Top 10 measures that matter were published online Feb. 16 in the Journal of Pain and Symptom Management. They are:
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 health care 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.
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