I'm often asked to describe the key elements behind the success of Advanced Palliative Care Organizations, and to cite specific examples across the country. Similarly, I'm asked how we determine the performance of communities and hospitals around palliative care. Simply put, we use the Dartmouth Medical Atlas, and seven outcome measures in the study considered by those whose palliative care knowledge I hold in high regard to be reliable indicators of the prevailing end-of-life care practices of hospitals and communities. These measures relate to place of death, referrals to hospice, use of intensive and acute hospital care during the final six months of life, and the coordination of physician care during those final months.
We then examine the hospital's performance in these palliative outcome measures, against local, state, and national performance data. Hospitals are assigned points based upon their performance against these standards, which when aggregated reflect their Palliative Performance Score. Hospitals are then graded, as follows, based upon their score.
100 - plus A best practice, exemplar
75-99 B solid performance, commendable, aspiring leader
50-74 C common performance, middle-of-the-road
25-49 D below-average performance, needs considerable improvement
less than 25 E complete overhaul necessary of current practices
Curious about your hospital(s) performance in palliative care? Drop me a line at firstname.lastname@example.org.
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