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Hospice Organization to Launch National Quality Initiative to Improve Care

Goal to improve hospice and palliative care delivery and outcomes

July 3, 2006 - This September, the National Hospice and Palliative Care Organization will launch a national, quality initiative designed to help hospice providers build organizational excellence and improve hospice and palliative care delivery and outcomes.  The Quality Partners program will be unveiled at NHPCO’s annual Management and Leadership Conference in New York City, September 11 – 13, 2006.

 

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Two years in the making, the Quality Partners initiative encompasses ten key components of quality that will offer providers a clear framework throughout the hospice organization – providing the hospice with the opportunity for a 360 degree surveillance of the entire operation, both clinical and non-clinical areas.

 “The overall goal of Quality Partners is to help hospice providers measurably show organizational excellence and demonstrate improvement efforts across all areas of hospice operations,” said Judi Lund Person, vice president, division of quality and access at NHPCO. “All sectors of the healthcare industry are focusing on quality issues and our new initiative will provide tools and resources that ultimately will result in better care at the bedside of patients and families.”

NHPCO board member Dr. Diane Meier, director of the Center to Advance Palliative Care at Mount Sinai School of Medicine in New York City, in her address at NHPCO’s Clinical Team Conference in April, acknowledged the challenge of defining quality, beyond the most basic level of “I know it when I see it.”

If patients and families are to rely upon consistent, reliable high-quality care from their hospice and palliative care providers, there has to be a way to clearly define quality, assess it, measure it, compare it and improve it, she explained. Providers need a way to quantify quality. That requires measures that are simple, inexpensive, easy to use, and connected to actual quality of care — not just paper exercises to satisfy external regulators.

Quality can be understood as desired health outcomes, as defined by the recipients of health care, according to Larry Beresford a freelance writer for NHPCO.

"Obviously, we know quality when we see it, even if we don’t always agree on its hallmarks. Hospice professionals receive verbal expressions of gratitude while standing at the grocery checkout line and thank-you letters from bereaved families to indicate that they provided a valued service. But is that enough? Most quality experts say no — because it does not document actual outcomes of service or offer a basis for comparison between providers," writes Beresford..

The thing that’s missing in this rule-of-thumb view of quality is consistency — providing the same high level of care to every patient and family, says NHPCO president Donald Schumacher. “Quality is a buzz word in health care today — but how do people mean it? Not just clinical care, but in terms of all aspects such as the quality of your business ethics, compliance with laws and regulations, and how you treat your own staff and volunteers,” he says.

“Some hospice people don’t yet understand that payment eventually will be attached to quality measurement. That will be a tremendous motivator, beyond the desire to satisfy yourself and prove to yourself that your contributions to the lives of patients and families are the best they can be and continually getting better,” Schumacher explains.

“The real excitement of a commitment to quality is in your relationship with your patients and families and your community. Demonstrating your commitment to quality will also go a long way toward lifting employee morale and job satisfaction.”

The Quality Partners campaign is designed to assist hospice providers in preparing for the Quality Assessment/Performance Improvement (QAPI) process outlined in the proposed Medicare Hospice Conditions of Participation, expected to be final in 2008.

Clinical Excellence Collaborative

As part of the new Quality Partners initiative, NHPCO has created the Quality Partners Clinical Excellence Collaborative. This is a unique, nine-month program based on the Institute for Health Care Improvement (IHI) model for improvement.

The Collaborative will offer participating teams of three to six people with training, resources, and support to make improvements in clinical excellence.  The Collaborative has been designed to help providers integrate an ongoing quality improvement process into their business plans in such a way that measurable, improved outcomes for patients and families will result.

The first training session for the inaugural Collaborative will take place as a pre-conference event on September 10 in New York. Registration for this offering will be limited to the first 20 teams.  Informational conference calls for NHPCO members, to help explain the Collaborative, have been scheduled for July 12, 1:30 to 2:30pm and July 13, 4:00 to 5:00pm (EDT). NHPCO members wishing to participate in one of these calls should contact Lin Noyes Simon at lsimon@nhpco.org.

Over the course of the next two months, NHPCO will work to familiarize its members with the initiative as well as explain its key concepts and put them in a helpful context for hospice and palliative care providers and professionals.

For a look at the ten components and additional information on the QP Collaborative, visit www.nhpco.org/quality.

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