The Quest for Quality

Quality care is one of those vague and elusive phrases.  Most of us believe we are providing quality services and use the term freely to promote our program.  After all, we know that quality assurance is built right into statute and the regulations we must adhere to as hospice providers.  And then there are the industry standards…quality measures assigned to just about anything that can be assessed.  Yet, do we really know what quality care is, looks like and moreover, how it is achieved? 

It probably goes without saying why we aspire to quality care. I hope we all agree we need to assure quality care for those individuals and their families who come to us for assistance, counsel, guidance and support at one of the most profound times of their lives.  Those we are charged with helping deserve nothing less than our best.  Additionally, we need to strive for quality to keep our industry standards high.

So, first a definition. An internet search for a definition of “quality” hospice and palliative care yielded little. Looking to our own WI Bureau of Health Services -Division of Quality Assurance (DQA), Centers for Medicare and Medicaid Services (CMS) and National Hospice & Palliative Care Organization (NHPCO) there are lots of quality indicators and measures but an actual definition is not readily offered. On their website, the Agency for Healthcare Quality and Research (AHQR) has a general definition on quality care and a whole book was found, Medicare:  A Strategy for Quality Assurance that took on Defining Quality Care in Chapter 5.

A concise working definition of quality hospice and palliative care exists somewhere, but for now it looks as though we are given a myriad of tools to interpret quality care.  While we continue our quest, perhaps we can turn to the Medicare Hospice Conditions of Participation and begin to figure out what quality care should look like, with their general definition of palliative care.  It goes like this:  patient- and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering throughout the continuum of illness.  It involves addressing physical, intellectual, emotional, social, and spiritual needs and facilitates patient autonomy, access to information, and choice.

          Unfortunately, we’re now back to having to define patient- and family-centered care, but we’ll save that for another time. 

         Next up, The Quest for Quality  – Why Education Matters.

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