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J Pain Symptom Manage. 2016 Feb;51(2):155-62. doi: 10.1016/j.jpainsymman.2015.10.019. Epub 2015 Nov 17.

Methodological Research Priorities in Palliative Care and Hospice Quality Measurement.

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Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. Electronic address:
University of Iowa College of Nursing, Iowa City, Iowa, USA.
Division of Adult Palliative Care, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Ariadne Labs, Boston, Massachusetts, USA; Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard School of Public Health, Boston, Massachusetts, USA.
Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA.
Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA; David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Corporal Michael J. Crescenz VA Medical Center-Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA; School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
University of Rochester School of Nursing, Rochester, New York, USA.


Quality measurement is a critical tool for improving palliative care and hospice, but significant research is needed to improve the application of quality indicators. We defined methodological priorities for advancing the science of quality measurement in this field based on discussions of the Technical Advisory Panel of the Measuring What Matters consensus project of the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association and a subsequent strategy meeting to better clarify research challenges, priorities, and quality measurement implementation strategies. In this article, we describe three key priorities: 1) defining the denominator(s) (or the population of interest) for palliative care quality indicators, 2) developing methods to measure quality from different data sources, and 3) conducting research to advance the development of patient/family-reported indicators. We then apply these concepts to the key quality domain of advance care planning and address relevance to implementation of indicators in improving care. Developing the science of quality measurement in these key areas of palliative care and hospice will facilitate improved quality measurement across all populations with serious illness and care for patients and families.


Palliative care; advance care planning; hospice care; pain measurement; patient satisfaction; quality indicators; quality of health care

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