VA charts improvement in end-of-life care plans
As part of its "1997 Performance Agreement," the Veterans Health Administration has instituted a number of quality indicators for network directors nationwide. The end-of-life performance measure counts the proportion of:
. . . patients with a terminal diagnosis or condition in final stages of illness, receiving ongoing care through VA, who have documentation of an individualized plan for comprehensive, coordinated, end of life care services that minimizes physical and psychological suffering and optimizes the patient’s quality of life.
Conformance with this indicator can be demonstrated in one of the following two ways: (1) admission to a community hospice program or a VA palliative care or hospice or home-based primary care program; or (2) an individualized care plan containing discussion of care and treatment alternatives and advance directives; effective symptom management; psychosocial and spiritual support; support for family caregivers; and continuity of care. Between the 3rd and 4th quarters of fiscal year 1997 (April-June and July-September), compliance with this standard increased from 52% to 67%.
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