Improving Access to Quality Palliative Care
We’re creating a tipping point in patients seeking and receiving high-quality palliative care.
Palliative care is still equated with the withdrawal of care, especially in diverse communities. Misperceptions about palliative care, gaps in its availability, and variability in quality mean older adults and others aren’t receiving the benefits of this specialized field of medicine that provides relief from the symptoms and stresses of serious illness.
We continued our support of the Center to Advance Palliative Care (CAPC) to improve the quality of palliative care for older adults living with serious illness. A grant ending in 2019 supported CAPC’s transition to a membership model that will help sustain it financially. A new grant funds:
- Expanding access to high-quality community-based palliative care;
- Improving frontline clinician skills through the first-ever John A. Hartford Foundation Tipping Point Challenge;
- Partnering with the American Hospital Association to drive uptake of palliative care; and
- Addressing palliative care financing and operational barriers through learning collaboratives of Accountable Care Organizations and Medicare Advantage plans.
- Community-based palliative care is being mapped and spread by CAPC, including to states through a partnership with the National Academy of State Health Policy.
- More than 1,500 health systems participated in the first Tipping Point Challenge, which recognizes health systems and their clinicians for completing skill-building courses in palliative care. Twenty-four organizations won in different categories and another 70 achieved “Honor Roll” status.
- The second Tipping Point Challenge, to be announced in 2020, will focus on the development of innovation in the care of serious illness.
Learn more about CAPC’s work to improve palliative care.
National POLST
We’re helping people plan for serious illness and medical emergencies.
Respecting people’s preferences for care during serious illness is paramount, but it requires planning and documentation. Approximately one-third of adults in the United States have an advance directive, but these are typically legal documents and not medical orders, and often leave out what should happen in the case of a medical emergency.
We supported National POLST, which has developed the first-ever national Physician’s Orders for Life-Sustaining Treatment (POLST) form, based on forms that have typically varied by state. This portable medical order is intended to guide future decision-making around a patient’s care. It derives from conversations between a clinician and patient about the patient’s conditions, prognoses, treatment options, and goals for their care.
- National POLST released the first National POLST Form, making it easier to:
- Know and honor patient treatment wishes throughout the United States;
- Conduct research and quality assurance activities; and
- Educate patients and providers about POLST so the process and form are understood and appropriately implemented.
- We are working with National POLST to disseminate guides for patients and guides for health professionals.
- POLST now exists at some level in all 50 states and in Washington, DC.
Learn more about National POLST.
Messaging for Better Serious Illness Care
We’re facilitating coordinated messaging about serious illness and end-of-life care through the Message.Lab project.
Can you imagine living well with serious illness and at the end of life? Most people are insufficiently informed about the care that a person with a serious illness or at end-of-life could and should receive. The result is that care may not match what matters to the patient or their family.
We funded the Message.Lab Project, which created a messaging toolkit after developing and testing common messaging principles and practical guidance to spur conversations about “What Matters.” The project has engaged nine leading organizations in palliative care, hospice, and advance care planning as a workgroup to guide the project. Their task was to align their internal messaging with the principles—and do it with maximum flexibility for individual sectors to use their own vocabulary.
- Six messaging principles were developed by the project workgroup in September 2019.
- The Message.Lab Project tested and refined the six principles in a series of focus groups with older adults, caregivers, and clinicians. The outcome: The principles were generally understood and effective.
- In 2020, the project workgroup members are exploring ways to share and adhere to the principles in real-world communications with their varied audiences.
Learn more about the Message.Lab Project.