Evaluating hospice services for improvement: a manageable approach

Over the past thirty years, hospice services across the United States have been established as a viable alternative for terminally ill patients. As expected, during this period of stabilization, hospice service leaders have invested the majority of their energy in securing funding, developing coalitions, and developing/implementing services. All of this work has occurred to support the primary aim of symptom control for patients through use of pharmacotherapy, as well as provision of ancillary services by interdisciplinary teams consisting of nurses, social workers, pastoral care staff, occupational therapists, and others. Little attention has been given to assessing the effectiveness of this range of services in a holistic way. This paper presents a model of evaluation that is both manageable to implement and suitable to the political environments where hospice providers reside. The article demonstrates an approach that is collaborative and directs the evaluative process towards the improvement of services.