Center to Advance Palliative Care

Dates of Support: 1999–2011

Field of Work: Palliative and end-of-life care

Problem Synopsis: Advances in public health, preventive medicine, and medical technology have led to dramatic increases in the number of Americans living longer. While many people over age 65 enjoy good health for some time, eventually most adults will have one or more chronic illnesses often characterized by pain and frailty. The nation's health care system is not well suited to address the array of medical, social, emotional, and other needs of patients living for long periods with serious, but not immediately terminal, conditions.

Synopsis of the Work: During 1999–2011, the Center to Advance Palliative Care (CAPC) at the Mount Sinai School of Medicine undertook a range of initiatives to increase the number of hospitals able to provide palliative care, make hospital-based palliative care standard practice, and develop standards for palliative care programs.

To achieve these goals, CAPC selected and supported nine Palliative Care Leadership Centers (six funded by RWJF) based at hospitals across the country, led a consortium of organizations in developing consensus standards of palliative care, and demonstrated cost savings attributable to palliative care. In addition, CAPC provided ongoing in-person and online resources, and training via national seminars, audio grand rounds, and guidebooks.

Key Results

  • CAPC developed a new understanding of palliative care that shaped the thinking of physicians, patients, and policy-makers. By distinguishing palliative care from end-of-life or hospice care, CAPC expanded its audience to include patients with serious, but not immediately life-threatening, conditions. Physicians and their patients could work simultaneously on providing care aimed at both curing the condition and ensuring that patients were comfortable and stable.

    • By 2009, the number of hospitals providing palliative care increased by 138 percent, from 658 to 1,568.
    • The Palliative Care Leadership Centers had trained 1,029 teams from hospitals across the country, 80 percent of which had established their own palliative care programs within two years.
    • In 2006, the National Quality Forum endorsed a framework for preferred practices in palliative and hospice care. In 2011, the Joint Commission launched a Palliative Care Advanced Certification program.