Quality Measurement of Serious Illness Communication: Recommendations for Health Systems Based on Findings from a Symposium of National Experts

Justin J. Sanders, Joanna Paladino, Erica Reaves, Hannah Luetke-Stahlman, Rebecca Anhang Price, Karl Lorenz, Laura C. Hanson, J. Randall Curtis, Diane E. Meier, Erik K. Fromme, Susan D. Block

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Background: Communication between clinicians and patients fundamentally shapes the experience of serious illness. There is increasing recognition that health systems should routinely implement structures and processes to assure high-quality serious illness communication (SIC) and measure the effectiveness of their efforts on key outcomes. The absence, underdevelopment, or limited applicability of quality measures related specifically to SIC, and their limited application only to those seen by specialist palliative and hospice care teams, hinder efforts to improve care planning, service delivery, and health outcomes for all seriously ill patients. Objective: We convened an expert stakeholder symposium and subsequently surveyed participants to consider challenges, opportunities, priorities, and strategies to improve quality measurement specific to SIC. Results: We identified several barriers and opportunities to improving quality measurement of SIC. These include issues related to the definition of SIC, methodological challenges related to measuring SIC and related outcomes, underutilization of technologies that can facilitate measurement, and measurement development, and dissemination. Conclusions: Patients, clinicians, and health systems increasingly align around the importance of high-quality communication in serious illness. We offer recommendations for various stakeholder groups to advance SIC quality measurement. Enthusiasm and a sense of urgency among health systems to drive and measure communication improvements inform our proposal for a set of example measures for implementation now.

Original languageEnglish
Pages (from-to)13-21
Number of pages9
JournalJournal of Palliative Medicine
Volume23
Issue number1
DOIs
StatePublished - Jan 2020

Keywords

  • communication
  • expert stakeholders
  • quality measures
  • serious illness

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