“We are issuing a national call to action for healthcare systems, communities, and policymakers to work together to improve the lives of those with advanced illness,” said David Longnecker, MD, chief clinical innovations officer, The Coalition to Transform Advanced Care (C-TAC), who co-chaired the NQP Advanced Illness Care Action Team that developed the issue brief. “We must ensure that in our highly fragmented and uncoordinated healthcare system, the goals, choices, and preferences of individuals with advanced illness care are the guiding North Star of all care decisions.”
Advanced illness may impair daily activities, reduce mental and physical capabilities, and lead to frequent medical treatments and visits. Measuring the quality of advanced illness care services is critical given the increasing number of older Americans facing advanced illness. Over the next two decades, the number of people over 65 will nearly double to more than 72 million, or one in five Americans. The vast majority of people with advanced illness will be in this group, although advanced illness can occur at any age.
Advanced illness care encompasses a range of services that bridge families and caregivers, communities, and the healthcare system. People with complex medical needs benefit from palliative care in various settings—including home, community, hospital, hospice, nursing homes, and other long-term care facilities—especially at the end of life.
The NQP issue brief highlights six key preferences of high-quality, person-centered advanced illness care, including purpose and connection, physical comfort, emotional and psychological well-being, family and caregiver support, financial security, and peaceful death and dying. It also provides snapshots of organizations that have embraced one or more of these key areas and pinpoints opportunities to use quality measurement to transform advanced illness care.
The NQP Advanced Illness Care Action Team includes 25 patients, care providers, physicians, nurses, spiritual advisors, and other experts from the public and private sectors. More than two dozen individuals and organizations that are leading robust initiatives to transform advanced illness care in the Unites States also provided input.
“NQP’s advanced illness care initiative unites the nation’s most influential stakeholders to spur national dialogue and action on this critical issue,” said Susan Frampton, PhD, president of Planetree, who also co-chaired the NQP Action Team. “Now, more than ever, we must recognize that better patient engagement improves healthcare quality and lowers costs.”
NQP’s guidance on advanced illness care is timely. In January 2016, the Centers for Medicare & Medicaid Services issued a final rule that reimburses physicians and other healthcare providers to engage in end-of-life discussions with patients. However, recent studies show that nearly two-thirds of physicians do not feel adequately trained to address these challenging and often culturally taboo subjects. The issue brief highlights preferences of individuals with advanced illness to help guide these conversations.
Action Team members discussed the issue brief in depth during a November webinar attended by hundreds of individuals from more than 170 organizations. Dozens of individuals and organizations also participated in a November #hpm chat that reached an estimated 138,000 accounts and resulted in nearly 250,000 impressions.
For more information, contact nationalqualitypartners@qualityforum.org.