Quality and Palliative Care?  No, thanks! …or maybe; Yes, thanks!

Hospital, home care and clinic quality management has historically been reserved for compliance with required (CMS or Joint Commission) indicators and/or compliance with accreditation standards. With the move to continuous quality improvement at the end of the last century, many health care quality functions expanded to process improvement and specialty certification. Contemporary healthcare quality has expanded to potentially include patient safety, infection prevention, root cause analysis, LEAN, and six sigma to name a few. Pay for Performance has shifted our priorities and challenged our approach to readmissions, surgical injury, mortality and patient safety and we are all on the journey to becoming highly reliable. These priorities have become more and more challenging as our patients age and have many complex healthcare needs.  

Donald M. Berwick, MD, MPP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement stated “The ultimate measure by which to judge the quality of a medical effort is whether it helps patients (and their families) as they say it. (BMJ, 1997). Palliative care principles including but not limited to effective goals of care discussions, care planning and symptom management are shown to improve the patient experience including length of stay, readmissions and cost of care. Incorporation of these principles into redesigning processes of care and readmission reduction strategies are evidence based best practice, yet not routinely incorporated into process improvement. We have an opportunity. Quality and Palliative Care are natural partners in the ongoing effort to improve processes and outcomes of patient care. The challenge is to engage this partnership when we come together for improvement. Are we up to the challenge? I hope we say, Yes, Thanks!  

Suzie Feuling, MS, RN, BSN, CPHQ
Director, Quality, Case Management, Medical Staff and Infection Prevention
Aurora West Allis Medical Center