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The New York City Palliative Care Quality Improvement Collaborative
David A Gould1, Joanne Lynn, Deborah Halper
1United Hospital Fund, New York City, NY, USA. dgould@uhfnyc.org
Joint Commission Journal on Quality and Patient Safety
|June 15, 2007
Summary
Quality improvement collaboratives effectively enhanced palliative care services for terminally ill patients in New York City. This approach improved advance care planning, pain management, and care coordination, building stronger palliative care networks.
Area of Science:
- Healthcare Quality Improvement
- Palliative Care Services
- End-of-Life Care
Background:
- Palliative care for fatal chronic conditions presents significant cost, complexity, and reliability challenges.
- A quality improvement collaborative was established in New York City to enhance palliative care delivery.
- The initiative aimed to build healthcare provider capacity in applying quality improvement (QI) methodologies.
Purpose of the Study:
- To develop and implement a collaborative model for improving palliative care services.
- To enhance the capacity of healthcare providers in utilizing quality improvement techniques.
- To foster the growth of palliative care programs and networks.
Main Methods:
- The Palliative Care Quality Improvement Collaborative (PC-QuIC) adapted the Institute for Healthcare Improvement's Breakthrough Series model.
- Four year-long implementation cycles were conducted, involving 82 teams overall.
- Each wave included 18-24 interdisciplinary teams focused on palliative care.
Main Results:
- Significant improvements were observed in key areas such as advance care planning, pain management, family support, and care coordination.
- Teams demonstrated increased familiarity and proficiency with continuous quality improvement (CQI) techniques.
- The collaborative successfully supported the development and expansion of palliative care programs and networks.
Conclusions:
- Rapid-cycle QI projects within a defined geographic area can efficiently build and sustain enhanced end-of-life care.
- Broad organizational involvement is crucial for the success of such collaborative efforts.
- PC-QuIC highlighted the progress in palliative care while also identifying challenges in its continued refinement and expansion.
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