Palliative care programs evaluating their inpatient clinical services should examine four areas: (1) symptom assessment and management; (2) patient-centered goals of care; (3) support to patients and caregivers; (4) and transition management.
Assessing the quality of palliative care, particularly in hospices, requires effective measurement tools. Numerous tools exist but have not been evaluated.
Since 2000, in its nine Palliative Care Leadership Centers, the Center to Advance Palliative Care (CAPC) has measured operational, clinical, customer satisfaction and financial data. In 2008 CAPC formed a consensus panel to evaluate measurements of quality of care and customer satisfaction. The panel was interdisciplinary, comprised of academic professionals, veterans health and community hospital administrators, single hospitals, large health centers, adult and pediatric programs and hospices.
The CAPC panel approved numerous tools for assessing the quality of palliative care and customer satisfaction. This consensus report describes four key domains of measurement; each description cross-references appropriate data collection tools. The measurements address only data that is under the direct control of the palliative care team.
- In deciding how often to record clinical and patient data, a reasonable standard is: (1) an initial comprehensive assessment; (2) at least one daily reassessment for moderate to severe symptoms; and (3) a comprehensive reassessment every three days.
- The CAPC panel approved several measurement tools developed organically at individual institutions.
Program directors need accurate assessment tools and standards for improving palliative care services. The recommendations of the CAPC panel represent minimum levels of documentation. The ultimate goal of this research is to make high-quality palliative care available to every community in the U.S.