Palliative Care Services (PCS) increase the quality of care and improve resource utilization for patients with serious illness and those approaching the end of life. Because PCS increase value, many hospitals have established PCS over the past decade. With the expansion of PCS to over 1600 hospitals nationwide, the focus has shifted from establishing PCS to understanding and improving the quality of care delivered. A key step to improving quality is measuring patient‐level outcomes and linking them to structures and processes of care to define best practices. Establishing a common dataset collected by PCS would enable them to compare outcomes, establish benchmarks, define best practices, and improve quality.
To create the Palliative Care Quality Network (PCQN), a quality improvement collaborative focused on improving the quality of the care for seriously ill hospitalized patients and those approaching the end of life. A core component to realizing this goal is the development and implementation of a core dataset.
The Palliative Care Quality Network (PCQN), established in 2009, consists of 20 hospital PCS in California. Using a modified Delphi process, the PCQN has defined a core dataset of 23 data elements that is feasible to collect in real time, helpful at the bedside in caring for patients, and targeted at key processes and outcomes. Data elements include principal diagnosis, location at time of consult request, number of family meetings held, palliative performance scale score, whether code status was clarified, disposition, which members of the PCS team saw the patient and daily scores for pain, dyspnea, anxiety and nausea. The data elements constitute a limited dataset to minimize privacy concerns. PCQN members collect data in the course of patient care and enter data into the secure, PCQN web‐based database. The database provides instantaneous reports of demographics, disposition, processes and outcomes, and symptoms scores for each site with comparisons to the entire PCQN. In the first 3 months, 4 sites have entered over 1500 patient encounters providing comparison data to drive quality improvement efforts.
The PCQN is an innovative quality improvement collaborative that allows hospital PCS to monitor and track processes and outcomes of care including patient symptoms and to compare themselves to others. Establishing common metrics and benchmarks will help PCS identify norms of practice, best practices, and advance the practice of palliative care. With ongoing success, the PCQN will expand membership nationwide. The PCQN supports and fosters a professional community that contributes to the professional development of each member and the future direction of Palliative Care with the ultimate goal of improving the quality of care provided to patients and families in need.
To cite this abstract:Pantilat S, Bragg A, O’Riordan D. The Palliative Care Quality Network: A Quality Improvement Initiative for Palliative Care Services. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 230. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/the-palliative-care-quality-network-a-quality-improvement-initiative-for-palliative-care-services/. Accessed March 28, 2020.