Defining and Measuring Quality
Because of the complexity of their needs, people with serious illness are especially vulnerable to poor quality care—particularly in the context of rising pressure to control costs. This collection helps payers, policymakers, and providers understand best practices for delivering quality of care during a serious illness, and to identify certifications that demonstrate adherence to third-party quality standards. Particular attention should be paid to the
National Consensus Project Clinical Practice Guidelines for Quality Palliative Care (4th edition), a foundational document that defines the components of quality care for people with serious illness, regardless of setting and applicable to clinicians in all specialties and disciplines.
What’s in the Toolkit
National Consensus Project (NCP) Clinical Practice Guidelines for Quality Palliative Care
The NCP guidelines foster consistent and high standards in the care of people with serious illness.
The National Consensus Project (NCP) Clinical Practice Guidelines are the national standard for high quality palliative care. National Consensus Project for Quality Palliative Care, 2018.
Other Relevant Clinical Guidelines
Best practice recommendations for disease treatment that include access to palliative care.
National accreditation standards for cancer care, requiring provision of palliative care services, navigation programs, and psychosocial distress screening.
ASCO Guideline calling for routine use of early and concurrent palliative care for advanced stage cancer patients.
ACC/AHA Guidance endorsing concurrent palliative care to improve quality of life for patients with symptomatic advanced heart failure.
Professional Certifications in Palliative Care
Specialty certification resources for clinicians from all disciplines.
The Hospice and Palliative Medicine examination is administered by the American Board of Medical Specialties (ABMS) and the American Osteopathic Association (AOA).
The Hospice and Palliative Credentialing Center (HPCC) website offers information and testing dates for hospice and palliative nursing certification.
In May 2018, the Social Work Hospice and Palliative Care Network launched an evidence-based, test-based Advanced Palliative Hospice Social Worker Certification (APHSW-C).
Certification in hospice and palliative care is available through the National Association of Social Workers for a bachelor's or master's level social worker.
Palliative care specialty certification through the Board of Chaplaincy Certification Inc. (BCCI), an affiliate of the Association of Professional Chaplains.
The College of Pastoral Supervision and Psychotherapy offers training and accreditation for chaplains, pastoral supervisors, and pastoral psychotherapists.
SPCP promotes exceptional patient care by advancing pain and palliative pharmacists through education, development, and research in collaboration with the transdisciplinary team.
Program Certifications in Palliative Care
Both hospitals and community-based providers can demonstrate adherence to national quality guidelines through program certification by accrediting organizations.
Designations connoting high-quality specialty palliative care in both inpatient and community care settings. Includes a comparison of eligibility criteria, standards, and requirements for all available program designations.
Recognizes palliative care programs in TJC-accredited hospitals that demonstrate exceptional quality.
Recognizes hospital palliative care programs in that demonstrate exceptional quality. DNV GL base accreditation is not required.
Recognizes palliative care programs delivered by hospice or home health agencies that demonstrate exceptional quality.
Recognizes palliative care programs delivered by hospice, home health, or private duty nursing agencies that demonstrate exceptional quality.
CoC accreditation requirement for pediatric cancer programs to provide palliative care services either onsite or by referral.
Recognizes home-based programs that demonstrate exceptional quality. CHAP base accreditation not required, and home-based medical groups are eligible. Community Health Accreditation Partner, 2019.
Quality Standards and Incentive Programs
Examples and recommended standards for health plans to use to incentivize—or require—access to palliative care and adherence to quality guidelines.
A blog describing two straight-forward and effective programs, one at Anthem Inc and one Highmark Blue Cross Blue Shield, incentivizing access to palliative care in network hospitals.
Structures and processes that all hospitals and skilled nursing facilities need to assure access to high-quality care for people with serious illness.
Measurement and Benchmarking
Information about national palliative care registries that support the field of palliative care; benchmark and compare your program to peer programs as well as collect actionable metrics for quality improvement.
PCQN is a membership organization that operates a national palliative care registry for clinical data. Their continuous learning collaborative provides teams with tools, data, and support to demonstrate value, build strong teams, and promote resilience in their clinicians.
GPCQA is a membership organization that operates QDACT, a national palliative care registry for clinical data. Membership allows palliative care teams to benchmark performace against others, and provides easy-to-use tools for improving quality.
The Collaborative seeks to unify and integrate existing national palliative care registries.
Per capita utilization and spending for specific populations in Medicare. CAPC Payment Accelerator, 2017.
Use this toolkit to select program measures that demonstrate value to stakeholders and support quality care delivery. Overcome common measurement obstacles and synthesize program data.
Diane E. Meier, MD, FACP, FAAHPM
Director, Center to Advance Palliative Care
Allison Silvers, MBA
Vice President, Payment and Policy
Maggie Rogers, MPH
Director of Research
Brynn Bowman, MPA
Chief Strategy Officer
Constance Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN
Center to Advance Palliative Care