Designing a Hospital Inpatient Palliative Care Program
As of 2017, more than 90% of hospitals with 300+ beds had an inpatient palliative care service. Hospital palliative care programs support patients in crisis by:
- Identifying and addressing sources of suffering
- Helping patients make goal-concordant care-plan decisions
- Planning for appropriate care post-discharge
If you are starting—or expanding—an inpatient service, always begin with a needs assessment.
What’s in the Toolkit
Making the Case for Hospital Palliative Care
Make the case for your program’s impact on care quality and costs.
One-page infographic to introduce your organization leaders, referrers, and health plans to the quality, satisfaction, and utilization improvements resulting from palliative care.
Key messages for health system leaders, applicable across settings. Center to Advance Palliative Care, revised 2018.
Tools to make the case for palliative care resources and financial partnerships, including: the palliative care evidence base, and downloadable tools for presenting the case.
Engage stakeholders—patients and families, organizational leadership, referrers, and financial partners—to guide program design.
Evaluating patient need, service requirements, and stakeholder priorities for the inpatient program.
Articulate the rationale for a hospital palliative care program or expanded service, and identify patient demographic and utilization data that guide the design of services. Center to Advance Palliative Care, 2015.
Planning document for stakeholder interviews. Center to Advance Palliative Care, 2015.
Tips and sample questions for conducting stakeholder interviews during the needs assessment process. Center to Advance Palliative Care, 2015.
Synthesize needs assessment data to guide program design. Center to Advance Palliative Care, 2015.
Annotated template for a formal concept proposal for the inpatient palliative care program. Center to Advance Palliative Care, 2015.
Patient population, staffing mix, and service components all contribute to program design, which is guided by information from your needs assessment.
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.
Incorporating needs assessment and stakeholder priorities into design of a high-quality inpatient program.
Palliative Care Leadership Centers (PCLC) offer hospitals two days of in-person, customized operational training and one year of mentoring.
Comprehensive manual on hospital-based palliative care program design. Center to Advance Palliative Care, 2008.
Estimate patient volume using national comparative data from the CAPC National Palliative Care Registry. Center to Advance Palliative Care, 2015.
Planning worksheet for coverage, service norms, and staffing on the inpatient team. Center to Advance Palliative Care, 2015.
Project staffing FTE per discipline based on expected patient volumes. Center to Advance Palliative Care, 2015.
A catalog of design decisions and trade offs to refine your program design. Center to Advance Palliative Care, 2015.
Toolkit for finding the right patients at the right time to address gaps in care.
Hire and onboard your staff, manage program operations, and ensure a healthy high-functioning team using this toolkit.
Journal of Palliative Medicine, 2008.
Estimate start-up costs, operational costs, and reimbursement for the hospital palliative care program.
Building a budget and a business plan for the inpatient program. Includes business planning tools.
Toolkit for building a business plan and budget, forming financial partnerships, and operating the program efficiently.
Toolkit with billing and coding best practices for palliative care services delivered in the hospital or the community.
National Data and Published References
National data provide a basis for comparison as you design your inpatient palliative care program.
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.
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.
A comprehensive profile of hospital palliative care programs participating in the National Palliative Care Registry™ from 2009 to 2015. Highlights national trends to promote standardization and improve the quality of hospital palliative care. Center to Advance Palliative Care, 2017.
Diane E. Meier, MD, FACP, FAAHPM
Director, Center to Advance Palliative Care
Lynn Hill Spragens, MBA
Spragens & Gualtieri-Reed
Tom Gualtieri-Reed, MBA
Spragens & Gualtieri-Reed
Andrew E. Esch, MD, MBA
Medical Education Consultant, Center to Advance Palliative Care
Brynn Bowman, MPA
Chief Strategy Officer