IMPROVEMENTS &INNOVATIONS IN END OF LIFE CARE

Rand Corporation, Santa Monica CA

Investigators

Abstract

The RAND/Institute for Health Improvement Initiative to Improve Quality at the End of Life will host a National Congress on Qualitative Improvement in End of Life Care on February 11-13,2001 in Atlanta, Georgia. Americans are now likely to live for months of years with the diseases that will eventually kill them, such as advanced heart and lung disease, stroke, dementia, and many cancers. Many of these individuals are disabled during this period and tend to experience episodes of serious complications, with death occurring at an unpredictable time somewhere along the way. Our present acute care-centered delivery and payment systems are not designed to meet the unique needs of these individuals in a coordinated-or compassionate manner. Despite these challenges improvements in the care delivered to this population are being made in a number of settings. However, word of these improvements has mostly been spread anecdotally and has been disseminated through non- traditional vehicles, rather than in the mainstream medial and public health literature. This lack of an intellectual "home" for the field has prevented the wider adoption of quality improvement techniques. The RAND/IHI Initiative, along with other committed organizations, is working to surmount these barriers. The three-fold purpose of the National Congress is to: 1) Widely disseminate information about what we and others have learned about best practices and research findings related to quality improvement in end of life care and create a series of opportunities for new insights and learning, even at the conference; 2) Use the dynamic of the conference to provide the basis for collaboration and information sharing related to clinical care within and between participating provider organizations, ensuring rapid dissemination of insights learned in the participants' work after the conference; and 3) Formally launch the new RAND/Institute for Healthcare Improvement Initiative to Improve Quality at the End of Life, which is dedicated to supporting the innovation and evaluation practice that is essential to creating a care system that people coming to the end of life can depend on. The intended short-term outcome of the conference will be to increase participants' knowledge about proven best practices and research findings that they can apply to making rapid, measurable improvements in the care that they deliver to patients who are at or near the end of life. In addition, we hope to help participants shift from mere curiosity about quality improvement to a real motivation, readiness, and confidence that they can return to their practice sites ready to become engaged in the process themselves. The Congress will include a combination of activities to meet the needs of participants with varying learning styles, including large-groups lecture style learning (plenary sessions), small group teaching (breakout sessions), one-one discussion and information support (storyboards), and small group interaction (lunch discussion tables).