Position Statements

Statement on Clinical Practice Guidelines for Quality Palliative Care

Approved by the Board of Directors
June 2006

In May 2004, the National Consensus Project for Quality Palliative Care published Clinical Practice Guidelines for Quality Palliative Care that guide the development and structure of new and existing palliative care services and promote high quality care. These guidelines are applicable to specialist-level palliative care delivered in a range of treatment settings as well as to the work of providers in primary treatment settings where palliative approaches to care are integrated into clinical practice. The American Academy of Hospice and Palliative Medicine (AAHPM) contributed to the development of these guidelines and encourages their adoption by other professional societies, medical institutions, medical providers, and insurers.

The goal of palliative care is to prevent and relieve suffering, and to support the best possible quality of life for patients and their families, regardless of their stage of disease or the need for other therapies, in accordance with their values and preferences. Palliative care is both a philosophy of care and an organized, highly structured system for delivering care. Palliative care expands traditional disease-model medical treatments to include the goals of enhancing quality of life for patient and family, optimizing function, helping with decision-making and providing opportunities for personal growth. As such, it can be delivered concurrently with life-prolonging care or as the main focus of care.

Palliative care is operationalized through effective management of pain and other distressing symptoms, while incorporating psychosocial and spiritual care according to patient/family needs, values, beliefs and culture(s). Evaluation and treatment should be comprehensive and patient-centered, with a focus on the central role of the family in decision-making. Palliative care affirms life by supporting the patient and family�s goals for the future, including their hopes for cure or life prolongation, as well as their hopes for peace and dignity throughout the course of illness, including the dying process and death. Palliative care aims to guide and assist the patient and family in making decisions that enable them to work toward their goals during whatever time they have remaining.

Comprehensive palliative care services often require the expertise of various providers in order to adequately assess and treat the complex needs of seriously ill patients and their families. Members of a palliative care team may include professionals from medicine, nursing, social work, chaplaincy, nutrition, rehabilitation, pharmacy and other professional disciplines. Leadership, collaboration, coordination and communication are crucial for effective integration of these disciplines and services.

The effort to integrate palliative care into all health care for persons with debilitating and life-threatening illnesses should endeavor to ensure that:

1. Pain and symptom control, psychosocial distress, spiritual issues and practical needs are addressed with patient and family throughout the continuum of care.


2. Patients and families obtain the information they need in an ongoing and understandable manner, in order to grasp their condition, prognosis and treatment options. In this process, their values and goals are elicited over time; the benefits and burdens of treatment are regularly reassessed; and decision-making about care is sensitive to changes in the patient�s condition.


3. Genuine coordination of care across settings is ensured through regular and high-quality communication between providers at times of transition or changing needs, and through effective continuity of care that utilizes the techniques of case management.


4. Both patient and family are prepared for the dying process and for death, when it is anticipated. Hospice options are explored, opportunities for personal growth are enhanced, and bereavement support is available for the family.

The statement and key elements are excerpted from Clinical Practice Guidelines for Quality Palliative Care. For more information, go to www.nationalconsensusproject.org or contact info@nationalconsensusproject.org or 412/787-1002.