Quality Metrics.

Quality care in the hospital setting generally looks at survival, functional ability, successful care transitions and quality of life. While quality care in the hospice setting generally looks at reducing symptom distress, improving caregiver outcomes, and reducing hospitalizations near the end of life. According to a study done by the Journal of Palliative Medicine called, A Review of the Essential Components of Quality Palliative Care in the Home, these “Six essential elements of quality palliative homecare were common across the studies: (1) Integrated teamwork; (2) Management of pain and physical symptoms; (3) Holistic care; (4) Caring, compassionate, and skilled providers; (5) Timely and responsive care; and (6) Patient and family preparedness.”

The study concludes to say, “The application of these elements must be relevant to the local community context. To create impactful, sustainable homecare programs, it is critical to capitalize on existing processes, partnerships, and assets.”

While there is a “Palliative Care Measures Project” being conducted through a cooperative agreement between RAND and the American Academy of Hospice and Palliative Medicine and funded by the CMS, these measures are far from being implemented. Those organizations who have some means of ongoing quality assessment and performance improvement efforts will be well positioned to easily implement new quality measures as they are formalized and will likely perform better on those areas if they have already been monitoring and addressing them in some way. What you choose to measure and how you engage staff to should further the initiatives of your individual organization and reflect the types of patients you are serving, their goals and in what setting.