Concerns must be addressed, officials say
Participants at the 18th Management and Leadership Conference of the Alexandria, VA-based National Hospice and Palliative Care Organization (NHPCO), held Sept. 7-9 in Phoenix, said that while they were looking forward to growth and expanded opportunities, they also were looking back at the problem of inconsistent care and concerns about the quality of hospice care. Anecdotal reports of such quality concerns were widely discussed at the conference, along with fears that just a few high-profile hospice scandals could seriously jeopardize hospice’s current favorable standing in America.
"We have enjoyed a very good reputation in our communities, and we want to see that continue," NHPCO chairwoman Maureen Hinkelman said during an open forum at NHPCO’s conference about how to tackle quality concerns. All regions of the country are reporting concerns about hospice quality, she added. "We want to open the dialogue and begin to address the issue ourselves."
Among the suggestions to emerge at the forum were greater emphasis on business ethics, revisiting hospice’s core values, publication of a national hospice quality report card, and mobilization of hospice executives who could visit hospices under NHPCO’s sponsorship to consult on quality improvement. It was also pointed out that providers have a responsibility at the local level to forthrightly address reported quality concerns among their neighbors.
"When I hear about horrible hospice care, it hurts us all. I feel there has to be some saber rattling," said Martha Barton of Pikes Peak Hospice in Colorado Springs, CO. "I think it’s frightening, it’s growing, and it’s deepening."
Concerns about quality come in a variety of forms, according to NHPCO president J. Donald Schumacher, so there is no single way to address them. "NHPCO members are very concerned about the variability in quality. There is bad hospice care out there, and I think we need to stop it. All hospices are going to get painted with the brush of bad apples," he said.
"My issue is not with the ownership or tax status of a hospice, but with the quality of care it provides," Schumacher said. "To be sure that the care being provided is good and that everybody who needs the care gets it — that’s our job." He suggested that a new approach to hospice accreditation, perhaps provided by an organization that is affiliated with or closely related to NHPCO, may be needed. In addition to some new form of accreditation, what’s needed is a combination of more education for providers, a Good Housekeeping-type seal of approval for hospice, and more hospices doing quality self-assessment, he said.
"I loved the suggestion at the forum this evening of giving some of the senior people in the industry who may be retiring some time at NHPCO’s sponsorship to go around and help hospices develop their programs," Schumacher said.
NHPCO has developed a self-assessment quality initiative called the Quality Partners Program, which so far has about 200 participating agencies. To be identified as a Quality Partner, a hospice completes and submits the 2002 National Data Set Survey and a Standard of Practice Self-Assessment questionnaire, which is based on NHPCO’s hospice standards.
Participants at the 18th Management and Leadership Conference of the Alexandria, VA-based National Hospice and Palliative Care Organization said that while they were looking forward to growth and expanded opportunities, they also were looking back at the problem of inconsistent care and concerns about the quality of hospice care.
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