Archive for November, 2010

Engage with Grace

Engage With Grace is a movement aimed at having all of us understand and communicate our end-of-life wishes. This Thanksgiving, have a conversation with your loved ones about what their preferences would be. To learn more please go to

Academy Voices Vital Role of Palliative and Hospice Care in Improving Quality of Health Care

Many health care initiatives launched by the Affordable Care Act focus on improving the quality of health care. The Academy and its members have been participating in these efforts, trying to bring wider visibility to the role that palliative care and hospice care can play in improving the quality of health care for patients with serious, advanced illness. Here’s a brief recap of some of the recent activity:

  • The Palliative Care and End-of-life Care workgroup of the National Priority Partners, (convened by the National Quality Forum), held an all day workshop on November 2 to come up with priorities to promote the diffusion of palliative care throughout the health care system. Numerous AAHPM members either presented or participated, including Sean Morrison, Sarah Friebert, Javier Kane, Karl Lorenz, Christine Ritchie, and Joan Teno. Diane Meier presented the opening overview, examining the current state of palliative and hospice care services and opportunities to improve access and close performance gaps. The speakers’ slides are posted on the NPP website.
  • AAHPM submitted comments to the Secretary of HHS on the National Health Care Quality Strategy and Plan. AAHPM’s public policy advisors see this plan as a critical document that will likely guide how federal energy and resources are spent over the next several years. AAHPM’s comments (which other Hospice and Palliative Care Coalition member organizations also submitted) made two main recommendations:
    • Add focus on patient-centered care guided by palliative care principles to measurement and accountability for all providers serving seriously ill patients.
    • Assure that specialty level palliative care and hospice services are broadly available and of demonstrably high quality.

Specific actions needed to achieve the above goals were also specified.

  • AAHPM also submitted comments (as part of the Hospice and Palliative Care Coalition) on the National Quality Forum measure gap agenda. Incredulously, the committee that ranked priorities for measures needed over the next few years ranked palliative care LAST. It received ZERO votes! The Coalition said in its comments: “the Coalition urges the NQF to recognize the urgency of making palliative care measures a high priority on the national measure development agenda.”

AAHPM’s Quality Task Force, chaired by Sydney Dy, would appreciate hearing from you about how we are articulating the need for quality palliative and hospice care. Please leave a comment and let us know whether you think we are succeeding in making the case.

Every continent except Antarctica

Julie Bruno, Director of Education, AAHPM

I had the opportunity to represent AAHPM at the 18th International Congress of Palliative Care in Montreal in early October. This was my first time at this Congress and, with the help of AAHPM member and Congress attendee, Dr. Nancy Hutton, we talked with people practicing palliative care from every continent of the world except Antarctica at the opening reception. (Thank you, Nancy!) Many stopped by to learn about AAHPM and many were interested in our educational resources: The Primer of Palliative Care, Unipac QR, the Unipac Series, the newly released recording of the AAHPM Intensive Board Review Course and the upcoming Annual Assembly in Vancouver. It was interesting as a staff member to consider how AAHPM resources may serve a more international audience. I also appreciated greeting several AAHPM members who dropped by to say hello.

I would like to thank AAHPM President Dr. Sean Morrison for spending time staffing the AAHPM booth with me. Throughout the week, we talked with attendees about Board certification and on line resources – both the AAHPM website for professionals as well as the patient family website, . The Congress was trilingual (Spanish, French and English). If we think we struggle with a clear definition of hospice and palliative care in the US, imagine the challenges at this international conference!

Two stories from my time at the conference are staying with me… Mr. Li Ka-shing has developed National Hospice Service Program in Mainland China through the Li Ka Shing Foundation (LKSF). They have 220 field staff, 31 hospice units and have served 94,212 patients as of August 2010. They target underprivileged patients and provide free home-based care with a key focus on pain relief. The LKSF foundation has donated a total of US$ 40M, 89% spent on medications. He concludes his story by saying that they are serving 1% of the people who are dying in China. ( That took my breath away!

The other story came from Susan Kristiniak from Abington Memorial in Philadelphia. She shared the story of attending the 2009 AAHPM and HPNA Annual Assembly in Austin along with some of her colleagues. They were so energized by the conference that they went home and developed a four-hour nursing in-service training with a goal of reducing unrelieved pain. Using hospital data, they were able to prioritize need and started with the post-surgical unit that included 77 nurses who were mandated to attend this training. The unit showed a significant reduction in pain scores. Based on the feedback from the nurses on that unit, the training has been refined and is being rolled out on the orthopedic unit. To learn more about this project, Susan welcomes emails at

The International Congress happens every other year. It is worth the experience.