Defining and Measuring Quality

Last Reviewed: March 4, 2019

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

Last Updated: January 29, 2019

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.

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

2016 Commission on Cancer, Cancer Program Standards: Ensuring Patient Centered Care

Last Updated: February 21, 2019

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

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

Last Updated: February 21, 2019

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

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2013 American College of Cardiology Foundation/American Heart Association Management of Heart Failure Guidelines

Last Updated: February 3, 2019

ACC/AHA Guidance endorsing concurrent palliative care to improve quality of life for patients with symptomatic advanced heart failure.

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Specialty certification resources for clinicians from all disciplines.

Physician Certification

Last Updated: March 1, 2019

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

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Nursing Certification

Last Updated: February 3, 2019

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

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Social Work Certification - SWHPN

Last Updated: February 3, 2019

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).

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Social Work Certification - NASW

Last Updated: February 3, 2019

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.

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Chaplaincy Certification - BCCI

Last Updated: March 1, 2019

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

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Chaplaincy Certification - CPSP

Last Updated: March 1, 2019

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

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Society of Palliative Care Pharmacists (SPCP)

Last Updated: February 3, 2019

SPCP promotes exceptional patient care by advancing pain and palliative pharmacists through education, development, and research in collaboration with the transdisciplinary team.

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Physician Assistants in Hospice and Palliative Medicine (PAHPM)

Last Updated: February 3, 2019

PAHPM educates PAs on the fields of Palliative and Hospice medicine, grows these areas of medicine through the use of PAs, and advocates for PA rights in hospice care.

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

The Joint Commission (TJC) Advanced Certification for Palliative Care

Last Updated: February 3, 2019

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

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DNV GL Palliative Care Program Certification

Last Updated: February 23, 2019

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

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The Joint Comission Community-Based Palliative Care Certification Program

Last Updated: February 3, 2019

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

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

Last Updated: February 3, 2019

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

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American College of Surgeon's Commission on Cancer (CoC)

Last Updated: March 1, 2019

2016 guidelines require access to palliative care as a quality standard for oncology care.

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

Anthem Quality Hospital Incentive Program (Q-HIP)

Last Updated: February 3, 2019

Anthem's Q-HIP scores its network hospitals for availability of interdisciplinary palliative care specialists; hospital policy on palliative care; screening patients on admission for palliative care needs; and clinician training.

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Blue Shield California Palliative Care Certification Requirement

Last Updated: February 3, 2019

Blue Shield has required all network agencies delivering home-based palliative care to achieve program certification through either The Joint Commission (TJC) or the Accreditation Commission for Health Care (ACHC) by January 1, 2020.

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Recommended Standards for Hospitals and SNFs

Last Updated: July 30, 2019

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

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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.

National Palliative Care Registry™

Last Updated: February 27, 2019

A publicly available national database of palliative care programs and operational metrics, free of charge to all palliative care programs. Submit program data to receive reporting and to track program growth and capacity over time. Compare your program to peers to help make the case for adequate staffing and program quality.

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Palliative Care Quality Network (PCQN)

Last Updated: February 3, 2019

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.

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Global Palliative Care Quality Alliance (GPCQA)

Last Updated: February 3, 2019

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.

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Palliative Care Quality Collaborative

Last Updated: February 3, 2019

The Collaborative seeks to unify and integrate existing national palliative care registries.

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Utilization and Spending Benchmarks for Medicare Populations

Last Updated: February 3, 2019

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

Measurement Best Practices

Last Updated: March 4, 2019

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.

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