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- Title
Improving Access to Palliative Care through an Innovative Quality Improvement Initiative: An Opportunity for Pay-for-Performance.
- Authors
Bernacki, Rachelle E.; Ko, Danielle N.; Higgins, Philip; Whitlock, Sandra N.; Cullinan, Amelia; Wilson, Robin; Jackson, Vicki; Dahlin, Constance; Abrahm, Janet; Mort, Elizabeth; Scheer, Kenneth N.; Block, Susan; Billings, J. Andrew
- Abstract
Background: Improving access to palliative care is an important priority for hospitals as they strive to provide the best care and quality of life for their patients. Even in hospitals with longstanding palliative care programs, only a small proportion of patients with life-threatening illnesses receive palliative care services. Our two well-established palliative care programs in large academic hospitals used an innovative quality improvement initiative to broaden access to palliative care services, particularly to noncancer patients. Methods: The initiative utilized a combination of electronic and manual screening of medical records as well as intensive outreach efforts to identify two cohorts of patients with life-threatening illnesses who, according to University HealthSystems Consortium (UHC) benchmarking criteria, would likely benefit from palliative care consultation. Given the differing cultures and structure of the two institutions, each service developed a unique protocol for identifying and consulting on suitable patients. Results: Consultation rates in the target populations tripled following the initiative: from 16% to 46% at one hospital and from 15% to 48% at the other. Although two different screening and identification processes were developed, both successfully increased palliative care consultations in the target cohorts. Conclusion: Quality improvement strategies that incorporate pay-for-performance incentives can be used effectively to expand palliative care services to underserved populations.
- Subjects
HEALTH services accessibility; HEALTH insurance &; economics; MEDICAL databases; INFORMATION storage &; retrieval systems; QUALITY assurance; PATIENT selection; MEDICAL referrals; ACADEMIC medical centers; CATASTROPHIC illness; HEALTH facility administration; EVALUATION of organizational effectiveness; PALLIATIVE treatment; ECONOMICS
- Publication
Journal of Palliative Medicine, 2012, Vol 15, Issue 2, p192
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2011.0301