Antea Worldwide Palliative Care Conference

Rome, 12-14 November 2008

ABSTRACT FORM

Presenting author MEASURING QUALITY OF CARE AT THE END OF LIFE: RESULTS FROM A US
PROJECT TO DEVELOP QUALITY MEASURES AND MEASUREMENT
Anna Schenk
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abstract
• Pain and other symptoms
• Palliative care for cancer patients
• Palliative care for non cancer
patients
• Paediatric palliative care
• Palliative care for the elderly
• The actors of palliative care
• Latest on drugs
• Pain
• Illness and suffering through
media
• Marginalisation and social stigma
at the end of life
• Palliative care advocacy projects
Measuring the quality of end of life care presents many challenges. This presentation will
summarize the results of the PEACE project, a project implemented in the US to identify quality
measures for use in end of life care and develop an instrument providers could use to monitor
their quality of care.
The project was sponsored by the US Centers for Medicare & Medicaid Services (CMS) in
anticipation of the release of new regulations that would require hospices to participate in quality
improvement activities beginning in late 2008. Using the National Concensus Project
framework and care domains as a guide, we identified existing quality measures and gathered
data on their use including quality measure rates, when available. A data collection pilot was
conducted to gather data for 60 potential quality measures for which no previously collected data
were available. The data pilot included chart-review and organizational data from 14 hospices
and 126 patients.
Quality measure rates for 103 potential measures were shared with a National Technical Expert
Panel (TEP). The TEP used four criteria to evaluate potential QMs: importance, scientific
soundness, feasibility, and usability. A set of 27 patient-centered quality measures for hospice and
palliative care were identified and recommended to CMS and posted on a public website for use
by hospices for internal quality improvement.
A common set of measures is an important goal with the potential to advance the science of
quality improvement in hospice and palliative care. The PEACE project identified potential
quality measures and tools but additional testing is needed. Lack of agreement on how to
measure some domains of care limits development of quality measures. Quality measurement is
a nascent science in hospice and palliative care. Testing of quality measures will provide
information about which measures could be most useful and effective for broader use in
benchmarking or research.

• Prognosis and diagnosis

communication in
different cultures
• Communication between doctor-
patient and patient-
equipe
• Religions and cultures versus
suffering, death and
bereavement
• Public institution in the world:
palliative care policies
and law
• Palliative care: from villages to
metropolies
• Space, light and gardens for the
terminally ill patient
• End-of-life ethics Session: Palliative care quality indicators
• Complementary therapies Chair of the session: Dott. Carlo Peruselli
• Education, training and research
• Fund-raising and no-profit
• Bereavement support
• Volunteering in palliative care
• Rehabilitation in palliative care
• Palliative care quality indicators