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 END-OF-LIFE
CARE
Increasing the number of Americans who receive
high-quality palliative care at the end of life.
September saw the broadcast on PBS of “On Our Own Terms:
Moyers on Dying.” The four-part documentary by the award-winning
journalist Bill Moyers was an important part of the End-of-Life
(EOL) Team’s efforts to help people be more comfortable having
conversations about death and dying, and to raise expectations when
it comes to care of the dying. The Foundation contributed $2.75
million to the production, much of it focused on outreach and support
for community coalitions formed as a result of the series.
The work of the Team is also focusing on
the professional arena. Research has shown that medical and nursing
education curricula do not give enough attention to all aspects
of end-of-life care, including pain and symptom control, ethical
considerations, and communications and legal issues. To help address
this problem, the Foundation provided $2.2 million to the American
Association of Colleges of Nursing to train at least 500 nursing
school faculty and other key nursing leaders in end-of-life care.
This project will make use of teaching materials being developed
at the University of Washington School of Nursing under an earlier
Foundation grant.
Other research has shown that too many cancer
patients do not receive appropriate pain management, even though
guidelines indicate that cancer pain can be controlled up to 90
percent of the time. The Foundation provided $1.4 million to the
University of Wisconsin-Madison Medical School to support state
cancer pain initiatives to promote improved management of pain.
This effort takes advantage of new pain standards being developed
by the Joint Commission on Accreditation of Healthcare Organizations
and revised cancer pain guidelines being issued by the Agency for
Healthcare Research and Quality.
In the future, the EOL Team will continue
its work around professional education, institutional change, and
public engagement.
INFORMATION TRACKING
Improving public and private policymaking
by making available timely, accurate, and relevant information about
the health system.
As part of the Information Team’s work to provide public
and private policymakers with better information, the Foundation
continued its support of research into the changes our health care
system is undergoing. In April, we approved $43.5 million to continue
the work supported under our Health Tracking project. The
two-year grant funds four separate research projects. These include
The Center for Studying Health System Change’s core Community
Tracking Study, which is looking at how changes in the delivery
system are affecting people’s access to care; work at the University
of California, Berkeley, looking at the role of physician organizations
in care management; and, two projects at The RAND Corporation, one
assessing the quality of care nationally and across markets, and
one tracking variations in employer-sponsored health insurance coverage.
At the same time more decisions over health
care policy are being made at the state level, more states have
instituted term limits. As a result, many legislators are unfamiliar
with the range and detail of health policy issues. To help improve
state legislators’ understanding of issues, the Foundation
provided a three-year, $2-million grant to the National Conference
of State Legislatures (NCSL). Under the current project, which is
a renewal and expansion of a previous effort, the NCSL will hold
meetings and conferences, and disseminate a variety of information
products designed to help state legislators do their jobs in a more
informed manner.
The Information Team will continue its work
to enhance the links between policymakers and researchers, including
efforts to find new ways to package and disseminate information.
© Copyright 2002 The Robert Wood Johnson Foundation.
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