Emerging Quality Improvement Concepts to Enhance the Patient and Family Experience in Hospice and Palliative Care.
Most quality improvement in end-of-life care has been related to symptom management, goals
of care, cost-effectiveness, and adhering to patient preferences. The patient and
family’s experience of care, the environment of care, support for surrogate
decision-makers, and public engagement related to end-of-life care receive less attention.
We describe three new quality improvement models to improve the patient and family experience of care: 1) involvement
of the primary care providers throughout the patient’s disease course, 2) modeling of
decision-making behavior for surrogates using narratives, and 3) increasing engagement with
end-of-life care among the public at large.
We advocate for the continued development and evaluation of new care models to improve the quality of end-of-life care and the widespread sharing of best practices.
Palliative care refers to symptom management throughout the course of illness while hospice
care focuses on management of end-of-life care, typically in the final 6 months of life. The provision of hospice and palliative care is a high priority; however, there are not enough palliative care specialists to provide this care for every individual who needs it.
The American Academy of Hospice and Palliative Medicine reported 7,056 certified hospice and palliative care physicians in 2015 and leaders in the field have suggested that generalists can be important contributors to end-of-life care, reducing fragmentation of care and preserving existing therapeutic relationships.
It is critical to patients and families that primary care providers continue to be involved in the provision of end-of-life care for their patients.
Palliat Med Hosp Care Open J. 2017; 3(2): 22-25. doi: 10.17140/PMHCOJ-3-123
