Accountable and Transparent Palliative Quality Measures Will Improve Care

Area of Science:

• Healthcare Systems
• Palliative Care Research
• Clinical Program Development

Background:

• Hospice and palliative care have demonstrated successes, but scaling these services in real-world healthcare settings presents challenges.
• Financial incentives in healthcare, such as those in glide pathways, necessitate counterbalancing quality measures to safeguard patient-centered care.
• Existing quality measures serve purposes of improvement, accountability, and transparency, requiring careful consideration in program design.

Purpose of the Study:

• To explore strategies for building effective hospice and palliative care clinical programs within existing healthcare systems.
• To investigate the critical balance between financial incentives and quality assurance in delivering care to seriously ill patients.
• To identify research priorities for advancing hospice and palliative care at scale.

Main Methods:

• This study is a conceptual and literature-based investigation, drawing on experiences with glide pathways and quality measurement frameworks.
• It emphasizes the need for a balanced approach, integrating financial considerations with robust quality metrics.
• The paper advocates for democratizing research by engaging diverse researchers ('small r' and 'big R') in palliative care.

Main Results:

• Implementing financial incentives in palliative care requires concurrent quality measures to ensure care aligns with patient goals and values.
• A dual approach to quality measures (improvement and accountability) is necessary for effective oversight.
• The field requires significant research to develop innovative systems and models of care.

Conclusions:

• Future research should focus on creating innovative systems and care models to meet the needs of seriously ill patients and their caregivers.
• Advancing hospice and palliative care at scale necessitates democratized research and broader engagement of the scientific community.
• Balancing financial incentives with concrete quality measures is paramount for ensuring high-quality, patient-centered care.