No benchmarks exist? Create your own
Although there are no rules or regulations for palliative care programs that require the collection of visit data, the staff at Four Seasons, a hospice and palliative care agency in Flat Rock, NC, collect information on everything from pain scores to clinical information to progress notes.
"There are no benchmarks for palliative care that a program can use to measure the quality of care, so we are working with Duke University on a research project to develop a benchmark tool that can be used by multiple agencies," explains John Morris, MD, medical director of palliative care and vice president of clinical outreach for the agency. At this time, Four Seasons is the only agency using the tool for palliative care, but the staff is working with three other palliative care programs in the state to implement it, he says.
Even with one agency collecting data, the tool has been useful, says Morris. "We are able to identify trends in our care and our patient outcomes," he says. "This self-evaluation gives us an opportunity to identify areas in which we can improve."
The real value of the benchmark tool will be seen when the other agencies are using it and the data can be used to compare programs to each other, Morris adds.
The research partnership with Duke University has had other benefits, says Morris. "We have between eight and 10 research projects under way to evaluate different treatment protocols," he says. The projects rely on voluntary patient participation to compare the efficacy of the different protocols. "Patients enjoy participating in the projects and often say that it is their opportunity to contribute to science and leave a legacy that might benefit someone else," Morris says. The projects often are evaluating the use of different medications, he explains.
One of the more significant discoveries in a research project was the success of using methylnaltrexone bromide to treat opioid-induced constipation, says Morris. Because opioids are used to manage pain in most palliative care patients, constipation is a common side effect that affects the patient's comfort and quality of life, he explains. "We discovered through our research that this medication is very effective, and we changed our treatment protocols to include its use when appropriate," Morris says.
Four Seasons doesn't just keep its good ideas to itself. In addition to sharing and encouraging the use of the benchmark tool the program developed, a monthly Center of Excellence seminar is offered to palliative care directors and their team members. "This is a day-long seminar in which we share our best practices and offer advice to participants with questions about their programs," says Morris. The seminar costs $2,000 for the day and includes all members of the program team, he says.
"Palliative care is a great service for the community, and it makes sense to share information we've learned," Morris says.
Need More Information?
For more information about the Center of Excellence seminar, contact John Morris, MD, at (828) 692-6178, ext. 347 or [email protected].
Although there are no rules or regulations for palliative care programs that require the collection of visit data, the staff at Four Seasons, a hospice and palliative care agency in Flat Rock, NC, collect information on everything from pain scores to clinical information to progress notes.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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