Evaluation of the Robert Wood Johnson Foundation's Body of Work in End-of-Life Care

Evaluation conducted December 2005 through August 2007

    • March 27, 2009

About the Evaluation

From 1996 to 2005, the Foundation invested over $150 million to improve care for individuals at the end of life. This collaborative project conducts a cluster assessment of the entire body of work produced through the Foundation's grantmaking in end-of-life care. The focus of the assessment was not on individual projects as such, but rather how these projects, together, help create strategy.

Major Evaluative Topics and Questions

The evaluation addresses these four questions about the Foundation’s end-of-life strategy:

  • Was the strategy creation process sound?
  • Was an appropriate strategy well chosen, and was it well developed?
  • Was the strategy executed well, and was learning leveraged throughout the process?
  • What outcomes can be associated with the effort?

Summary of Methods

The lead evaluator was Patricia Patrizi of Patrizi Associates. The evaluator conducted:

  • multiple staff interviews;
  • reviewed 337 grants and complete files of 150;
  • interviewed 10 current and former RWJF staff;
  • interviewed 60 external, 39 grantees and 31 grantees;
  • reviewed seminal documents on grantee and national organization Web sites and in professional journals and reports; and
  • analyzed data according to three major objectives of the strategy: improve the knowledge and capacity of health care professionals and others to care for the dying; improve the institutional environment in health care institutions and in public policies and regulatory apparatus; and engage the public and professionals in efforts to improve end-of-life care.

Knowledge and Impact

The evaluation documented the seminal role the Foundation played in building the field, specifically through the following seven key efforts:

  1. Fortifying the identity of palliative care as a legitimate arena of medical and nursing practice.
  2. Building the base of knowledge as well as providing funding to organize and communicate it to others in the field.
  3. Fostering the development of a highly influential network of leaders emerging from the Project on Death in America’s Faculty Scholars Program.
  4. Supporting the creation of an agenda for the field.
  5. Building the institutional base of practice for palliative care in a medical setting.
  6. Developing core clinical and institutional practice standards, which also provided a strong basis for advocacy when standards are not being met.
  7. Motivating medicine to act by making the case to physicians both that their decisions have severe consequences for how their patients die, and that there are reasonable potential alternatives.