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

The NCP guidelines foster consistent and high standards in the care of people with serious illness

National Consensus Project for Quality Palliative Care, 4th edition

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.

RAND Systematic Review of Evidence Supporting the NCP Guidelines

Systematic review and grading of the evidence supporting each domain of the NCP Guidelines; reviews literature published between 2013 to 2017.

Best practice recommendations for disease treatment that include access to palliative care.

Optimal Resources for Cancer Care (2020 Standards)

National accreditation standards for cancer care, requiring provision of palliative care services, navigation programs, and psychosocial distress screening.

2017 American Society of Clinical Oncology (ASCO) Clinical Practice Guideline Update

ASCO Guideline calling for routine use of early and concurrent palliative care for advanced stage cancer patients.

American College of Cardiology Foundation/American Heart Association Management of Heart Failure Guidelines

ACC/AHA Guidance endorsing concurrent palliative care to improve quality of life for patients with symptomatic advanced heart failure (originally published in 2013 and updated in 2017), as well as management of adults with congenital heart disease.

Alzheimer's Association Dementia Care Practice Recommendations

The Alzheimer Association's 2018 dementia care recommendations, drawn on person-centered care principles.

Specialty certification resources for clinicians from all disciplines.

Physician Certification

The Hospice and Palliative Medicine examination is administered by the American Board of Medical Specialties (ABMS) and the American Osteopathic Association (AOA).

Nursing Certification

The Hospice and Palliative Credentialing Center (HPCC) website offers information and testing dates for hospice and palliative nursing certification.

Social Work Certification - SWHPN

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).

Social Work Certification - NASW

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.

Chaplaincy Certification - BCCI

Palliative care specialty certification through the Board of Chaplaincy Certification Inc. (BCCI), an affiliate of the Association of Professional Chaplains.

Chaplaincy Certification - CPSP

The College of Pastoral Supervision and Psychotherapy offers training and accreditation for chaplains, pastoral supervisors, and pastoral psychotherapists.

Both hospitals and community-based providers can demonstrate adherence to national quality guidelines through program certification by accrediting organizations.

Specialty Palliative Care Program Designation Crosswalk
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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.

The Joint Commission (TJC) Advanced Certification for Palliative Care

Recognizes palliative care programs in TJC-accredited hospitals that demonstrate exceptional quality.

DNV GL Palliative Care Program Certification

Recognizes hospital palliative care programs in that demonstrate exceptional quality. DNV GL base accreditation is not required.

The Joint Commission Community-Based Palliative Care Certification Program

Recognizes palliative care programs delivered by hospice or home health agencies that demonstrate exceptional quality.

Accreditation Commission for Health Care (ACHC) Distinction in Palliative Care

Recognizes palliative care programs delivered by hospice, home health, or private duty nursing agencies that demonstrate exceptional quality.

CHAP Palliative Care Certification

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.

Optimal Resources for Cancer Care (2020 Standards)

National accreditation standards for cancer care, requiring provision of palliative care services, navigation programs, and psychosocial distress screening.

Geriatric Emergency Department Accreditation Program

Three levels of certification available, managed by the American College of Emergency Physicians; requires clinical protocol to identify ED patients who might benefit from palliative care and facilitate access.

Examples and recommended standards to incentivize—or require—access to palliative care and adherence to quality guidelines.

Hospital Palliative Care Incentive Programs

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.

Recommended Standards for Hospitals and SNFs

Structures and processes that all hospitals and skilled nursing facilities need to assure access to high-quality care for people with serious illness.

Institute of Healthcare Improvement's Age-Friendly Health Systems

The Institute of Healthcare Improvement’s formal recognition program for hospital and health systems improving the 4Ms of care for older adults: what matters, medication, mentation, and mobility.

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.

Palliative Care Quality Collaborative (PCQC)

Collaborative that houses a new, unified palliative care registry that captures both program- and patient-level quality data.

Recommended Quality Measures
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Measures that can be used by payers and policymakers to ensure quality care for people living with serious illness.

Utilization and Spending Benchmarks for Medicare Populations
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Per capita utilization and spending for specific populations in Medicare. CAPC Payment Accelerator, 2017.

Measurement Best Practices

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.

Serious Illness Quality Alignment Hub National Strategic Plan

Consolidation of selected areas of focus and defined strategies to enhance accountability for access to palliative care and enhance the quality of those services. Center to Advance Palliative Care and National Quality Forum, 2020.

National Quality Forum Issue Brief: Opportunities for Advancing Quality Measurement in Community-Based Serious Illness Care

Insights, recommended strategies, approaches, and tools, and a snapshot of the current quality measurement landscape for serious illness. National Quality Forum (NQF).