The bundled aspect of hospice care that has been created by the structure of the CMS Hospice Benefit has both positives and negatives. On the one hand, the full suite of services is available to the patient and family and can be tailored to meet their unique needs. On the other hand, hospice providers have trouble teasing apart what part of that collective care model is really creating the positive change. Hospice providers tend to want to offer the full range of services to all families. This can create problems, especially for non-hospice palliative care provision where the reimbursement cannot support the full spectrum of interventions.
Gaining insight into what parts of the care model that are the most impactful is vital. A new study in Age and Ageing provides a systematic review of over 1,674 articles with in-depth analysis of 57 to find the key aspects of care that were associated with the greatest positive outcomes. They found that standardized interdisciplinary communication, volunteer involvement, and early intervention had the greatest impact on more home deaths, less hospitalization, and higher patient and family satisfaction. Regarding the interdisciplinary team, it was systematic communication within the team itself that was seen to impact care, not direct involvement with the patient.
The holistic hospice approach has been a very powerful tool in providing quality care for the seriously ill for decades. However, we now may need to tease the specific aspects of that care apart and apply those new, more nuanced tools to other forms of palliative and serious illness care. Identifying the precise change that is needed, matching the tools that best create that change, and applying those tools in a skillful and prescribed manner empowers providers to create powerful and sustainable care models that will meet the needs of patients and families, referral sources, funding sources, and organizational stewardship. Not every situation calls for the “hospice hammer.”
“Research Identifies the Most Essential Components of Palliative Care Programs” by Jim Parker, posted by Hospice News on November 3, 2023 and accessible at https://hospicenews.com/2023/11/03/research-identifies-the-most-essential-components-of-palliative-care-programs/