Background: Care for persons living with fatal chronic conditions is expensive and challenging, and can be unreliable. A quality improvement collaborative was conducted to develop capacity among health care providers in a single geographic area—New York City—to apply quality improvement methodology to palliative care services. Methods: The Palliative Care Quality Improvement Collaborative (PC-QuIC) modified the Institute for Healthcare Improvement's Breakthrough Series model by delivering four year-long implementation cycles, with 18–24 teams in each wave and 82 teams overall. Results: Substantial improvements were noted in most of the team projects (advance care planning, pain, family support, coordination of care), and substantial gains were made in familiarity with continuous quality improvement (CQI) techniques and in building palliative care programs and networks. Discussion: Collaborative rapid-cycle QI projects in a limited geographic area can be efficient in building and sustaining improved care for persons nearing the end of their lives, especially when the work involves the broad range of organizations that care for this patient population. PC-QuIC's experience illustrates the growing strength of palliative care services, but also demonstrates the challenges that confront further refinement and expansion of high-quality palliative care.
Document Type: Research Article
Publication date: June 1, 2007
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Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.
Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety