Course 1: Comprehensive Pain Assessment
Course 1 of 14
Conducting a comprehensive pain assessment to guide safe and effective treatment.
Diane E. Meier, MD, FACP, FAAHPM
Dr. Diane E. Meier, FACP, FAAHPM, is Director Emerita and Strategic Medical Advisor of the Center to Advance Palliative Care, a national organization devoted to increasing access to quality health care in the United States for people living with serious illness. Under her leadership the number of palliative care programs in U.S. hospitals tripled since 2002.
Widely regarded as a preeminent change agent, Dr. Meier has received numerous awards that recognize and celebrate her achievements. In September 2008, Dr. Meier was awarded a MacArthur Foundation Fellowship (MacArthur Genius Award). She was named one of “20 People Who Make Healthcare Better in the United States” by HealthLeaders Media in 2010, and was elected to the National Academy of Medicine of the National Academy of Sciences in 2013. In 2017 she received both the Gustav O. Lienhard Award of the National Academy of Medicine and the American Hospital Association’s HRET TRUST Award. Dr. Meier served as a Health and Aging Policy Fellow in Washington, DC, in 2009–10, working on the U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) and at the Department of Health and Human Services.
Dr. Meier has published more than two hundred works in peer-reviewed medical literature. Her most recent book, Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Reform, was published by Humana in 2014. She has been featured in the media numerous times, including the PBS NewsHour Brief But Spectacular and the New York Times Magazine.
Books:
- Kelley AS, Meier DE, (eds.). Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform. Humana Press: 2014. ISBN 9781493904068
- Hughes RG, Isaacs SL, Meier DE, (eds). Palliative Care: Transforming the Care of Serious Illness. Wiley/Jossey-Bass: March 2010. ISBN 9780470527177
- Cassel CK, Leipzig RM, Cohen HJ, Larson EB, Meier DE, (eds). Geriatric Medicine. 4th ed. New York: Oxford University Press, 2003. ISBN 0387955143
- Cassel CK, Leipzig RM, Cohen HJ, Larson EB, Meier DE, eds. Geriatric Medicine: An Evidence-Based Approach. 4th ed. New York: Springer-Verlag, 2003. ISBN 0387955143
- Morrison RS, Meier DE (eds). Geriatric Palliative Care. New York: Oxford University Press, 2003. ISBN 0195141911
Selected Publications:
- Meier DE, Lim B, Carlson MD. Raising the standard: palliative care in nursing homes. Health Affairs (Millwood) 2010 Jan-Feb;29(1):136-40. PMID 20048372
- Adler ED, Goldfinger JZ, Kalman J, Park ME, Meier DE. Palliative care in the treatment of advanced heart failure. Circulation 2009 Dec 22;120(25):2597-606. Review. PMID 20026792
- Weissman DE, Meier DE. Operational features for hospital palliative care programs: consensus recommendations. Journal of Palliative Medicine 2008 Nov;11(9):1189-94. PMID 19021479
- Morrison RS, Meier DE, Fischberg D, Moore C, Degenholtz H, Litke A, Maroney-Galin C, Siu AL. Improving the management of pain in hospitalized adults. Archives of Internal Medicine 2006;166:1033-1039.
- Meier DE. Palliative care as a quality improvement strategy for advanced, chronic illness. Journal of Healthcare Quality 2005;27: 33-39.
- Meier, DE; Morrison, RS. Palliative Care. New England Journal of Medicine 2004 (June)
- Meier DE; Thar W; Jordan A; Goldhirsch SL; Siu A; Morrison RS. Integrating case management and palliative care. Journal of Palliative Medicine 2004; Feb. 7(1):119-134
- Meier DE, Morrison RS. Autonomy reconsidered. New England Journal of Medicine 2002 Apr 4;346(14):1087-1089
- Meier DE, Back AL, Morrison RS. The inner life of physicians and care of the seriously ill. JAMA 2001 Dec 19;286(23):3007-3014
- Morrison R, Siu A, Leipzig R, Cassel C, Meier D. The hard task of improving the quality of care at the end of life. Archives of Internal Medicine 2000 Mar 27;160(6):743-7
Selected Original Peer-Reviewed Reports:
- Cassel JB, Spragens L, Bowman B, Rogers M, Meier DE. Palliative Care Leadership Centers are key to the diffusion of palliative care innovation. Health Affairs 2018;37:231-9.
- Meier DE, Back AL, Berman A, Block SD, Corrigan JM, Morrison RS. A national strategy for palliative care. Health Affairs 2017;36(7):1265-73.
- Spetz J, Dudley N, Trupin L, Rogers M, Meier DE, Dumanovsky T. Few hospital palliative care teams meet national staffing recommendations. Health Affairs 2016;35:1690-7.
- Meier DE. Measuring quality of care for the sickest patients. NEJM Catalyst February 2016 - http://catalyst.nejm.org/measuring-quality-of-care-for-the-sickest-patients/
- Dumanovsky T, Rogers M, Spragens LH, Morrison RS, Meier DE. Impact of staffing on access to palliative care in U.S. hospitals. Journal of Palliative Medicine 2015;18:998-9.
- Peter May, Melissa M Garrido, J Brian Cassel, Amy Kelley, Diane E. Meier, Charles Normand, Thomas J Smith, Lee Stefanis, and R. Sean Morrison. Prospective cohort study of hospital palliative care teams for inpatients with advanced cancer: earlier consultation is associated with larger cost-saving effect. Journal of Clinical Oncology 2015;33:1-10.
- Meier DE. Focusing together on the needs of the sickest 5%, who drive half of all healthcare spending. Journal of the American Geriatrics Society 2014;62:1970-72.
- Meier DE. ‘I don’t want Jenny to think I’m abandoning her’: views on overtreatment. Health Affairs 2014;33(8):1492
- Tamura MK, Meier DE. Five policies to promote palliative care for patients with end stage renal disease. Clinical Journal of the American Society of Nephrology 2013, June 6.
- Unroe K, Meier DE. Quality of hospice care for individuals with dementia. Journal of the American Geriatrics Society 2013; 61:1212-14.
- Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM, Ferrell BR, Loscalzo M, Meier DE et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. Journal of Clinical Oncology 2012;30:880-7.
- Morrison RS, Augustin R, Souvanna P, Meier DE. America’s care of serious illness: a state-by-state report card on access to palliative care in our nation’s hospitals. Journal of Palliative Medicine 2011; 14:1094-6.
- Meier DE. Increased access to palliative care and hospice: Opportunities to improve value in healthcare. Millbank Quarterly 2011;89:343-380.
- Morrison RS, Dietrich J, Ladwig S, Quill T, Sacco J, Tangeman J, Meier DE. Palliative care consultation teams reduce hospital costs for Medicaid beneficiaries. Health Affairs 2011;30:454-463.
- Carlson MD, Lim B, Meier DE. Strategies and innovations for delivering palliative care in nursing homes. Journal of the American Medical Directors Association 2011;12:91-98.
- Kelley A, Meier DE. Palliative care: A shifting paradigm. New England Journal of Medicine 2010;363:781-2.
- Meier DE, Lim B, Carlson, MD. Raising the standard: Palliative care in nursing homes. Health Affairs 2010;29:136-40.
From the Blog
From Boomers to Gen Z: Navigating Generational Differences on Health Care Teams
All about the challenges and benefits of age diversity on health care teams—plus four key principles for leading multigenerational teams successfully.
Dr. Diane Meier on the History and Future of Palliative Care Research
Why Diane Meier, MD, is excited about the future of palliative care research and was inspired by the 2024 AAHPM State of the Science keynote.
In Memory of Jim Block, MD
Diane E. Meier, MD, and friends write a loving tribute to their longtime friend and colleague, Jim Block, MD, sharing memories and lessons learned throughout the years.
Courses
Course 2: Matching the Drug Class to the Pain
Course 2 of 14
Selecting a safe and appropriate analgesic for patients with serious illness based on the pain assessment.
Course 3: Patient Factors that Influence Prescribing Decisions
Course 3 of 14
Patient and family factors that influence prescribing decisions for patients with serious illness.
Course 4: Assessing Risk for Opioid Substance Use Disorder
Course 4 of 14
Integrating routine risk assessment for substance use disorder when considering or using opioid therapy.
Course 5: Opioid Trials: Determining Design, Efficacy, and Safety
Course 5 of 14
Designing a safe and effective opioid trial for the patient with serious illness.
Course 6: Prescribing An Opioid
Course 6 of 14
Safe and appropriate opioid prescribing for the opioid-naive patient with serious illness.
Course 7: Prescribing Short-Acting Opioids: Four Case Studies
Course 7 of 14
Four indications for using short-acting opioids.
Course 8: Monitoring for Opioid Efficacy, Side Effects, and Substance Use Disorder
Course 8 of 14
Ongoing evaluation of opioid benefits, risks, and side effects for the patient with serious illness.
Course 9: Converting from Short-Acting to Long-Acting Opioids
Course 9 of 14
Guidance on safe conversion to long-acting opioids for patients with serious illness.
Course 10: Prescribing Practice and Opioid Conversions
Course 10 of 14
Prescribing practice for long half-life opioids, converting from one opioid to another, and accounting for incomplete cross-tolerance.
Course 11: Advanced Conversions and Opioid Side Effects
Course 11 of 14
Changing the route of opioid delivery, rotating opioids, advanced opioid conversions, and tapering opioids.
Course 12: Special Populations And Patient-Controlled Analgesia
Course 12 of 14
Safe opioid prescribing in older adults, cognitively impaired patients, children, and the imminently dying, including patient-controlled analgesia.
Course 13: Managing Pain in Patients At Risk for Substance Use Disorder
Course 13 of 14
Pain management for patients with serious illness and high risk for substance use disorder, including risk assessment, monitoring, and when to refer for safe pain management.
Course 14: Pain Management: Putting it All Together
Course 14 of 14
Safe opioid prescribing for patients with serious illness, using the Federation of State Medical Boards (FSMB) Guidelines for the Chronic Use of Opioid Analgesics.
Anxiety
After completing this course, learners will be equipped with evidence-based strategies to identify and treat anxiety in patients living with a serious illness.
Constipation
Constipation occurs in at least 70% of patients living with a serious illness and often goes unrecognized. After completing this course, learners will have the tools to successfully identify and manage the impact of constipation.
Depression
After completing this course, learners will have the tools to accurately identify and treat depression in patients living with a serious illness.
Dyspnea
After completing this course, learners will have the tools they need to manage dyspnea, including the physical causes of shortness of breath and the emotional impact on the patient.
Nausea/Vomiting
Nausea and vomiting are common symptoms of serious illness and can cause dangerous complications. After completing this course, learners will be equipped with practical skills to identify, manage, and reduce these symptoms.
Discussing Serious News
Course 1 of 5
Learn best practices for having patient-centered conversations about a serious illness diagnosis.
Discussing Prognosis With Patients and Caregivers
Course 2 of 5
Learn how to effectively discuss prognosis with patients and their caregivers.
Clarifying Patient Goals of Care
Course 3 of 5
Learn best practices for building trust, eliciting patient values, and having patient-centered conversations about goals of care.
Leading a Patient and Caregiver Meeting
Course 4 of 5
Learn to effectively lead meetings that help patients and caregivers become aligned around the patient’s goals.
Care Planning
Course 5 of 5
Learn techniques to help patients and their caregivers plan for the future, both during the early stages of a serious illness and as a disease progresses.
Relieving Distress in People Living With Dementia and Their Caregivers
Course 1 of 8
Gain an overview of the experience of living with dementia and learn how to relieve distress for patients with dementia, and their caregivers.
Discussing a Diagnosis of Dementia With Your Patient
Course 2 of 8
Learn how to discuss a dementia diagnosis with patients and caregivers in a way that is sensitive, clear, and supportive.
Communicating What to Expect Throughout the Trajectory of Dementia
Course 3 of 8
Learn techniques for supportive communication with people living with dementia, and their caregivers, to help them prepare for the challenges they may face as dementia progresses.
Planning for the Future After a Dementia Diagnosis
Course 4 of 8
Learn how to facilitate future planning discussions with people living with dementia, and their caregivers.
Available to non-members
Caring for Caregivers of People Living With Dementia
Course 5 of 8
Learn how to assess caregiver burden and connect caregivers with needed support systems.
Behaviors as a Form of Communication in People Living With Dementia
Course 6 of 8
Learn about the sources of behavioral symptoms for people living with dementia and how to respond to them.
Managing Mood and Sleep Disturbances in People Living With Dementia
Course 7 of 8
Learn how to relieve suffering from common mood and sleep disturbances in order to improve quality of life for people living with dementia, and caregivers.
Managing Complications in Advanced Dementia
Course 8 of 8
Learn about common health complications for people living with advanced dementia and how to support patients and caregivers.
Reducing Risks for Older Adults
This course provides context and best practices for identifying older adults at risk for poor outcomes, including falls, delirium, and caregiving challenges.
Supporting the Family Caregiver: The Burden of Serious Illness
Assessing and supporting caregivers of people with serious illness.
Care Coordination
Guidance for all clinicians on improving communication and ensuring smooth transitions of care for patients living with serious illness.
Non-Opioid Chronic Pain Management
Course 1 of 4
Clinical training on the biological basis of chronic pain, building patient trust, and non-pharmacological and non-opioid treatments for managing chronic pain in patients with serious illness.
Opioid Prescribing for Chronic Pain
Course 2 of 4
Clinical training on prescribing an opioid trial for the management of a seriously ill patient's chronic pain.
Risk Mitigation Strategies for Opioid Prescribing
Course 3 of 4
Clinical training course on universal precautions to identify and assess opioid misuse, and prevent opioid use disorder (OUD) in patients with serious illness.
Treatment Strategies for Opioid Use Disorder
Course 4 of 4
Clinical training course for identifying and managing opioid use disorder (OUD) in patients with serious illness, and treating pain in seriously ill patients with OUD.
A Palliative Approach to Care for Direct Care Workers
The role of the direct care worker in observing and reporting suffering in patients with serious illness.
Available to non-members
Introduction to Palliative Care
An introduction to palliative care, how it is delivered, its impact on quality of life, and the growing population of patients who need it.
Needs Assessment for the Hospital Palliative Care Program
Evaluating patient need, service requirements, and stakeholder priorities for the inpatient program.
Hospital Palliative Care Program Design
Incorporating needs assessment and stakeholder priorities into design of a high-quality inpatient program.
Building the Business Plan for Your Hospital Program
Building a budget and a business plan for the inpatient program. Includes business planning tools.
Introduction to Palliative Care in the Community
Defining community-based palliative care: which patients need it, how it is delivered, and how it differs from inpatient palliative care.
Needs Assessment: Ensuring Successful Community-Based Palliative Care
Evaluating patient need, service requirements, care settings, and stakeholder priorities for the community-based palliative care program.
Office-Based Palliative Care Program Design
Designing and implementing an office-based palliative care program, including clinical model and operational considerations.
Program Design for Palliative Care Delivered in the Home
Translating needs assessment into service design for the community-based palliative care program.
Building the Business Plan for Community-Based Palliative Care
Building a budget and a business plan for the community-based program. Includes business planning tools.
Improving Team Performance
Strategic planning for new or veteran programs, and a framework for identification of barriers to team efficiency and team health.
Consult Etiquette: Communicating with Referring Providers
Guidance for palliative care teams to build collaborative relationships with referrers.
Toolkit with billing and coding best practices for palliative care services delivered in the hospital or the community.
Includes 48 resources.
Hire and onboard your staff, manage program operations, and ensure a healthy high-functioning team using this toolkit.
Includes 70 resources.
Training and clinical tools for oncology clinicians from all disciplines.
Includes 30 resources.
Addressing the physical, psychological, and social impacts of serious illness, as well as the functioning of a healthy interdisciplinary team.
Includes 58 resources.
Training clinicians to support people with dementia and their caregivers, and guidance for quality improvement initiatives.
Includes 21 resources.
Integrating palliative care practices in the Emergency Department (ED) through training and collaboration.
Includes 28 resources.
Explore recent federal palliative care initiatives, learn about opportunities for federal action, and access guidance on policy implementation.
Includes 25 resources.
Strategic planning for program growth, including making the case, demonstrating value, and strengthening relationships with partners.
Includes 22 resources.
Practical tools and technical assistance for starting or growing a home-based palliative care program, from needs assessment to business planning, and more.
Includes 98 resources.
Tools and technical assistance for starting or expanding a hospital palliative care service.
Includes 25 resources.
Integrating palliative care practices in the ICU through training and collaboration.
Includes 35 resources.
Toolkit to support strategic planning, team leadership, and professional development for the palliative care leader.
Includes 31 resources.
Use this toolkit to evaluate models and design and operate a long-term care palliative care program.
Includes 33 resources.
Use this toolkit to select program measures that demonstrate value and support quality care delivery. Overcome common measurement obstacles and synthesize program data.
Includes 13 resources.
Tools and technical assistance for developing a palliative care program in a community clinic or office setting.
Includes 26 resources.
Toolkit for finding the right patients at the right time to address gaps in care.
Includes 31 resources.
Guidance on program design and program operations for the pediatric palliative care program.
Includes 65 resources.
A process and tools for stabilizing and strengthening palliative care programs during COVID-19.
Includes 6 resources.
Improving operations and training clinical staff to identify, stratify, and meet the needs of patients living with serious illness at the population level.
Includes 20 resources.
Improving productivity and efficiency to ensure team health and operating within budget.
Includes 21 resources.
Toolkit for building a business plan and budget, forming financial partnerships, and operating the program efficiently.
Includes 31 resources.
Use this toolkit to develop new programs and benefits for members with serious illness while driving improvements throughout the provider network.
Includes 41 resources.
A coordinated effort to develop a national strategic plan to incentivize the delivery of high-quality care for people living with a serious illness.
Includes 11 resources.
Tools for translating operational and service decisions into a realistic budget and business plan.
Includes 10 resources.
Use this toolkit to learn the issues and opportunities, explore recent state initiatives, and access guidance on implementation.
Includes 42 resources.
Tools to design and implement a training initiative for care teams from all specialties, to improve quality of life for patients and families living with serious illness.
Includes 27 resources.
Tools to develop financial partnerships including: making the case, contracting considerations, and how to use legal and financial advisers.
Includes 25 resources.
Tools to help payers, policymakers, and providers understand best practices for delivering quality care during a serious illness, and to identify certifications that demonstrate adherence to third-party quality standards.
Includes 33 resources.
These tools can be used to make the case for palliative care investment with organization leaders, health plans, colleagues, and community partners.
Includes 22 resources.