Hospital-Based Palliative Care: Quality Metrics That Matter

R ecent data indicate that practitioners incorporate the latest medical evidence into their treatment decisions only 50% of the time, preferring to practice what they are comfortable with (Trusko, Pexton, Harrington, & Gupta, 2007). The result has been an increased spotlight on standardizing care and measuring outcomes to improve health-care quality. Quality-improvement metrics are essential for driving hospital quality and measuring the effectiveness of quality programs. Hospital quality and outcomes can be measured using a variety of indicators that provide unique perspectives on quality of care. In the past, determinants of quality generally included clinical outcomes data and patientreported experiences in the hospital. More recently, hospital quality is reflective of adherence to evidencebased practice and is often defined and monitored by regulatory bodies such as the Joint Commission (JC) and the Centers for Medicare and Medicaid Services (CMS), which provide a more refined, less varied definition of quality. Indicators are also often determined by professional organizations, as standards are set by the experts themselves within the given organization. Overall, hospitals have a responsibility to evaluate ongoing data to ensure that safe, evidencebased, and quality care is consistently delivered. Quality care in the hospital has been linked to survival, functional ability, successful care transitions, and quality of life (CMS, 2015). A plethora of metrics exists to evaluate hospital-based quality care, but not all are related to quality cancer and palliative care. For example, the majority of CMS measures focus on cardiac care, pneumonia, postsurgical care, and mortality. However, in some ways, the CMS initiatives have driven quality measures in other disease states and for other hospital-based care including palliative care. This article will highlight hospital-based palliative care metrics measured in the article by Humphreys and Harman (2014) and discuss other metrics amenable for measuring palliative care programs (Humphreys & Harman, 2014).