Emerging Quality Improvement Concepts to Enhance the Patient and Family Experience in Hospice and Palliative Care

Abstract

Most quality improvement in end-of-life care has been related to symptom management, goals of care, cost-effectiveness, and adhering to patient preferences. The patient and family’s ex-perience of care, the environment of care, support for surrogate decision-makers, and public engagement related to end-of-life care receive less attention. We describe three new quality improvement models to improve the patient and family experience of care: 1) involvement of the primary care providers (PCP’s) throughout the patient’s disease course, 2) modeling of decision-making behavior for surrogates using narratives, and 3) increasing engagement with end-of-life care among the public at large. We advocate for the continued development and evaluation of new care models to improve the quality of end-of-life care and the widespread sharing of best practices.