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Clinical Practice Guidelines for Quality Palliative Care – National Consensus Project for Quality Palliative Care 2009

Definition of Palliative Care s. 15

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 the stage of the disease or the need for other therapies. 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. (…)

Core Elements of Palliative Care s. 8

The NCP agreed on the following key elements of palliative care.

• Patient population (…)
• Patient and family centered care (…)
• Timing of palliative care (…)
• Comprehensive care (…)
• Interdisciplinary team
• Attention to relief of suffering (…)
• Communication skills (…)
• Skill in care of the dying and the bereaved (…)
• Continuity of care across settings (…)
• Equitable access (…)
• Quality assessment and performance improvement (…)

Models of Palliative Care Delivery s. 20

There are several clinical models that have demonstrated quality care for patients and families. They include a variety of disciplines that collaborate to provide quality care. These include:

1. Hospice Care – a well-established program to provide patients with a prognosis of six months or less. As delineated within the Medicare Hospice Benefit, these services can be provided in the home, nursing home, residential facility, or on an inpatient unit.
2. Palliative Care Programs – institutional based programs in the hospital or nursing home to serve patients with life-threatening or life-limiting illnesses. Occur in hospital settings (academic community, rehabilitation) and skilled nursing facilities. Provide services to patients anywhere along the disease continuum between initial diagnosis and death. Can include a consultation team, a fixed-bed unit, or a swing-bed unit.
3. Outpatient Palliative Care Programs – occur in ambulatory care settings to provide continuity of care for patients with serious or life-threatening illnesses.
4. Community Palliative Care Programs – occur in communities as consultative teams who collaborate with hospices or home health agencies to support seriously ill patients who have not yet accessed hospice.