Justin J Sanders1,2,3,4, Joanna Paladino1,2,3, Erica Reaves5, Hannah Luetke-Stahlman6, Rebecca Anhang Price7, Karl Lorenz8, Laura C Hanson9,10, J Randall Curtis11,12, Diane E Meier13,14, Erik K Fromme1,2,3,4, Susan D Block1,2,3,4,15. 1. Harvard Medical School, Boston, Massachusetts. 2. Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 3. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 4. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts. 5. Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 6. Cerner Corporation, Kansas City, Missouri. 7. RAND Corporation, Arlington, Virginia. 8. Division of Palliative Care, Palo Alto VA Health Care System, Stanford University School of Medicine, Palo Alto, California. 9. Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina. 10. Division of Geriatric Medicine and Palliative Care Program, University of North Carolina Chapel Hill, Chapel Hill, North Carolina. 11. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Harborview Medical Center, Seattle, Washington. 12. Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington. 13. Center to Advance Palliative Care, New York, New York. 14. Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. 15. Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts.
Abstract
Background: Communication between clinicians and patients fundamentally shapes the experience of serious illness. There is increasing recognition that health systems should routinely implement structures and processes to assure high-quality serious illness communication (SIC) and measure the effectiveness of their efforts on key outcomes. The absence, underdevelopment, or limited applicability of quality measures related specifically to SIC, and their limited application only to those seen by specialist palliative and hospice care teams, hinder efforts to improve care planning, service delivery, and health outcomes for all seriously ill patients. Objective: We convened an expert stakeholder symposium and subsequently surveyed participants to consider challenges, opportunities, priorities, and strategies to improve quality measurement specific to SIC. Results: We identified several barriers and opportunities to improving quality measurement of SIC. These include issues related to the definition of SIC, methodological challenges related to measuring SIC and related outcomes, underutilization of technologies that can facilitate measurement, and measurement development, and dissemination. Conclusions: Patients, clinicians, and health systems increasingly align around the importance of high-quality communication in serious illness. We offer recommendations for various stakeholder groups to advance SIC quality measurement. Enthusiasm and a sense of urgency among health systems to drive and measure communication improvements inform our proposal for a set of example measures for implementation now.
Background: Communication between clinicians and patients fundamentally shapes the experience of serious illness. There is increasing recognition that health systems should routinely implement structures and processes to assure high-quality serious illness communication (SIC) and measure the effectiveness of their efforts on key outcomes. The absence, underdevelopment, or limited applicability of quality measures related specifically to SIC, and their limited application only to those seen by specialist palliative and hospice care teams, hinder efforts to improve care planning, service delivery, and health outcomes for all seriously ill patients. Objective: We convened an expert stakeholder symposium and subsequently surveyed participants to consider challenges, opportunities, priorities, and strategies to improve quality measurement specific to SIC. Results: We identified several barriers and opportunities to improving quality measurement of SIC. These include issues related to the definition of SIC, methodological challenges related to measuring SIC and related outcomes, underutilization of technologies that can facilitate measurement, and measurement development, and dissemination. Conclusions: Patients, clinicians, and health systems increasingly align around the importance of high-quality communication in serious illness. We offer recommendations for various stakeholder groups to advance SIC quality measurement. Enthusiasm and a sense of urgency among health systems to drive and measure communication improvements inform our proposal for a set of example measures for implementation now.
Authors: Eric H Li; William Ferrell; Tamar Klaiman; Pallavi Kumar; Nina O'Connor; Lynn M Schuchter; Jinbo Chen; Mitesh S Patel; Christopher R Manz; Ravi B Parikh Journal: JCO Oncol Pract Date: 2021-11-12
Authors: Anjali Varma Desai; Chelsea L Michael; Gilad J Kuperman; Gregory Jordan; Haley Mittelstaedt; Andrew S Epstein; MaryAnn Connor; Rika Paula B Villar; Camila Bernal; Dana Kramer; Mary Elizabeth Davis; Yuxiao Chen; Catherine Malisse; Gigi Markose; Judith E Nelson Journal: J Med Internet Res Date: 2021-02-17 Impact factor: 5.428
Authors: Lauren J Hunt; Sarah B Garrett; Gabrielle Dressler; Rebecca Sudore; Christine S Ritchie; Krista L Harrison Journal: J Pain Symptom Manage Date: 2020-10-20 Impact factor: 3.612
Authors: Joanna Paladino; Suzanne Mitchell; Namita Mohta; Joshua R Lakin; Nora Downey; Erik K Fromme; Sue Gullo; Evan Benjamin; Justin J Sanders Journal: Jt Comm J Qual Patient Saf Date: 2020-10-24
Authors: J M Maaskant; I P Jongerden; J Bik; M Joosten; S Musters; M N Storm-Versloot; J Wielenga; A M Eskes Journal: Int J Nurs Stud Date: 2020-12-24 Impact factor: 5.837