By INDU SPUGNARDI
This June, the Joint Commission released standards for its new Advanced Certification Program for Palliative Care. The standards were released in advance of the program's Sept. 1 start date to give hospitals time to assess their inpatient palliative care programs and prepare for the certification process.
Palliative care, or palliative medicine, is specialized medical care for people facing serious and chronic illness. It focuses on relief from symptoms, pain and stress; clear communication with patients, families and other health professionals about goals of care and plans to achieve those goals; and coordination of care across settings. Palliative care is provided by a team that includes physicians, nurses and other specialists. It is appropriate for any age and any stage in a serious illness and, unlike hospice, can be provided along with curative treatment.
The Joint Commission certification standards assess areas specific to palliative care, such as the composition and training of the palliative care team; support of patient decision making; effective communication and care coordination; and care planning that supports the patient's lifestyle, needs and values. Additional standards address broader issues, such as security of medical records, performance evaluation and improvement and patient safety.
A recent analysis of U.S. hospitals conducted by the Center to Advance Palliative Care found that hospitals are implementing palliative care programs at a rapid pace. In 2009, the number of programs in hospitals with 50 or more beds increased to 1,568, or 63 percent of U.S. hospitals in that size category, from 658 hospitals in 2000, or 24.5 percent of hospitals in the size category.
Research over the last decade demonstrates that palliative care improves quality of care, reduces costs and prolongs survival. These findings helped fuel the growth of palliative care programs. Advocates of palliative care predict continued growth as the number of people living with serious and chronic illnesses continues to rise and health care providers work to meet the triple aims of health reform — better care, healthier populations and lower costs.
While advocates are pleased with the growing number of palliative care programs, they want to ensure that the programs are effective. The Joint Commission's certification program is viewed as an important part of a broader effort to set clear standards on what constitutes a high-quality palliative care program. Other quality improvement efforts include a new project being undertaken by the National Quality Forum, a leading health care improvement organization, to endorse performance measures on key components of palliative care; increase the number of health care professionals trained to deliver palliative care and garner more funds for palliative care research.
The standards for the Joint Commission's voluntary certification program are based on the National Consensus Project's Clinical Practice Guidelines for Quality Palliative Care and the quality forum's National Framework and Preferred Practices for Palliative and Hospice Care Quality, both of which represent consensus achieved among leading national organizations working in the area of palliative care and hospice.
Catholic health care organizations may be well positioned to take advantage of the Joint Commission's certification program. The Center to Advance Palliative Care's 2008 analysis of hospital palliative care programs found that Catholic sponsorship was a feature commonly associated with hospitals that provided palliative care services.
Tina Picchi, executive director of the Supportive Care Coalition: Pursuing Excellence in Palliative Care, observed that the Joint Commission's standards "can appear daunting to programs with a small number of staff and resources, but they can be used as drivers for change — to help secure resources, train staff and increase awareness of palliative care within the organization." Picchi noted that the coalition, a group of 20 Catholic health care organizations committed to increasing access to high-quality palliative care, plans to carefully review the standards and discuss ways to leverage their collective experiences and resources to help interested hospitals prepare for certification.
The Center to Advance Palliative Care also is offering resources to assist hospitals with the certification process. More information about the Joint Commission's advanced certification program is available on its website.