Institute of Medicine (IOM)

Full access to CAPC tools and technical assistance that will help implement recommendations in the IOM report is reserved for members. Log in now if you're from a member institution. Or to learn more about membership, please call Member Services at 212-201-2674.


On September 17, 2014, the Institute of Medicine (IOM) released its report on improving quality of care near the end of life. However, the title of the report, Dying in America, is something of a misnomer. The report actually focuses extensively on people with serious and chronic illness of indeterminate prognoses, and why the current health care system has largely failed to meet their needs.

Call for Universal Education and Training in Practices of Palliative Care

The IOM report calls for two fundamental and profound changes in organized medicine, which have the potential to greatly improve quality of care for our sickest patients.

The first is a call for universal education and training for all health professionals and clinicians (e.g., physicians, nurses, social workers and others) in the core principles and practices of palliative care. These practices include pain and symptom management; the safe and effective use of opioids; skilled communication with patients and their families to help them determine their goals; how the health care system can help them achieve those goals; and seamless, well-coordinated and well-communicated care, across multiple settings, over time.

Palliative Care Must Integrate Social Support with Medical Needs

The second groundbreaking recommendation of the IOM report concerns coverage of both the social and medical needs of the most serious and complex patients. Approximately 40 percent of all medical spending is precipitated by unmet social support needs, including low literacy, language barriers, poor nutrition, unsafe housing, family violence, mental illness and—perhaps most important of all—the absence of support for exhausted and overwhelmed family caregivers.

As the palliative care field moves beyond hospitals to home-based care, long term care and other settings, its success and sustainability will depend on the ability to integrate social and medical support services.

CAPC features extensive operational and clinical training, tools and technical assistance based on fulfilling these needs. The goal is to bring best practices and delivery models to scale in the United States.

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