Palliative & Hospice Care: Framework and Practices
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Project Status: Completed
National Framework and Preferred Practices for Palliative and Hospice Care Quality
Access the final report: A National Framework and Preferred Practices for Palliative and Hospice Care Quality.
The Opportunity
Palliative and hospice care seek to prevent and relieve suffering and ensure the highest possible quality of life regardless of the age of the individual, stage of disease or need for other therapies. Palliative care is provided across a wide variety of settings and professional fields. It incorporates symptom control, including pain management, supportive care, respite care, rehabilitation, and terminal care. Over the past few years, demand for hospice and palliative care services has grown tremendously. In May 2004, the National Consensus Project reported on “clinical guidelines” for palliative care, and in November 2008 the National Priorities Partnership identified palliative and end-of-life care as one of the areas key to transforming the nation’s healthcare system.
About the Project
This project was completed in May 2006.
Objectives
This project led to the endorsement of a comprehensive framework for evaluating the quality of palliative and hospice care; a set of 38 preferred practices for delivering high-quality palliative and hospice care; and 9 recommendations for research to improve upon the measurement and evaluation of palliative and hospice care. Potential NQF-endorsed® performance measures for palliative and hospice care quality are considered under this framework. The framework is based, in part, on Clinical Practice Guidelines for Quality Palliative Care, issued in May 2004 by the National Consensus Project.
The framework items include definitions for palliative and hospice care; purpose of the framework; goals, principles, scope, structural/programmatic elements, and domains of palliative/hospice care; and levels of measurement, outcomes, preferred practices, and performance measures. The research recommendations identify pressing needs in the areas of structure and processes of care; physical, psychological/psychiatric, social, spiritual, religious, and existential, and cultural aspects of care; care of the imminently dying patient; ethical and legal aspects of care; and topics that cross domains.
Process
The NQF Board of Directors approved the formation of a Review Committee to review this framework. This project, like all NQF activities, involved the active participation of representatives from across the spectrum of healthcare stakeholders and was developed in accordance with the Consensus Development Process (CDP), version 1.7.
Funding
Funding for this project was provided by the Robert Wood Johnson Foundation.
Contact Information
For more information, please contact info@qualityforum.org or (202) 783-1300.
This project sought to endorse a national consensus framework for evaluating the quality of palliative and hospice care across all health settings and professions and achieve consensus on a set of preferred practices for palliative and hospice care based on the framework. Additionally, the work identified areas for research in palliative and hospice care quality measurement and reporting.
The project Review Committee, representing the full range of stakeholder perspectives, was formed following the process set forth in NQF’s Consensus Development Process.
Nominations for the steering committee were accepted from December 12 through January 10.
In January 2005, NQF began work around a palliative and hospice care framework and preferred practices. The work was rooted in the National Consensus Project’s 2004 Clinical Practice Guidelines for Quality Palliative Care.
The NQF Board of Directors appointed a Review Committee to oversee this project. The Review Committee met and considered the proposed framework, practices and research recommendations beginning in June 2005 through February 2006.
NQF received the voting package for this project on April 4, 2006. Memeber voting closed May 5, 2006.
The NQF Board of Directors approved a comprehensive framework for evaluating the quality of palliative and hospice care; a set of 38 preferred practices for delivering palliative and hospice care; and 9 recommendations for research to improve upon the measurement and evaluation of palliative and hospice care on May 17, 2006.
