Public awareness of advance care planning, palliative care and end-of-life options are key to improving end-of-life care in Massachusetts, according to a report prepared and released by UMass Medical School’s Commonwealth Medicine division.
The MA Expert Panel on End of Life Report - Looking Forward: 2014 and Beyond follows a state law that went into effect in December requiring health care providers to inform patients who have been diagnosed with a terminal illness or may benefit from hospice or palliative care about the options available. Those options include palliative care for management of pain and symptoms, and hospice care, which can help patients live in comfort and with dignity during the final months of life.
Commonwealth Medicine convened and hosted a summit of more than 50 experts in palliative and end-of-life care from across the state in 2014 to update the 2010 Patient-Centered Care and Human Mortality Report by the Massachusetts Expert Panel on End of Life Care. The report, which summarized the recommendations, was prepared after the summit.
Prior to the summit, Commonwealth Medicine distributed an online survey to a broader group of experts and advocates and summarized the findings to set the stage for the summit.
The survey identified the need for public awareness of the options for palliative and end-of-life care as the highest priority. The importance of this was reinforced during the summit. The proposed first step was to obtain funding for the creation of an entity to implement the 2014 panel’s recommendations, disseminate best practices and measure performance, according to the updated report.
Patient choice, patient engagement, quality and cost were cited by those attending the summit as important factors to consider in efforts to improve end-of-life care in Massachusetts. These factors were echoed in an unrelated report by the Institute of Medicine, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.
Commonwealth Medicine’s report details an updated plan of action based on the 2010 recommendations, including:
- Securing organizational and funding resources to develop and implement a public awareness campaign about advance care planning, palliative care and end-of-life options.
- Ensuring patients are engaged in advance care planning and health care professionals have the tools they need to prepare them to communicate compassionately with patients.
- Identifying palliative and end-of-life care educational resources in state institutions, and establishing core competencies and building accountability for communication between patients, families and health care providers.
- Developing and disseminating among health care institutions billing and financial system modifications to support patient-centered palliative and end-of-life care.
- Obtaining funding for an entity with broad stakeholder support responsible for ensuring excellence and accountability in palliative and end-of-life care.
- Determining measures for palliative and end-of-life care in clinical settings, and establishing state standards for high-quality care.