Palliative care guideline development process and role of project champion

Two non-profit organizations in Colorado provided the key to developing, disseminating and implementing a clinical guideline on palliative care in Colorado aimed at both health care providers and policymakers. Quality Life Institute approached HealthTeamWorks to develop and disseminate a one-page, front-to-back clinical guideline on palliative care. To develop the guideline, HealthTeamWorks convened a development committee including physicians, advanced-practice nurses, and experts in behavioral science, health communication and social work. Committee members identified existing evidence-based guidelines and conducted a literature review on palliative care. They determined the key issues that providers need to know to deliver appropriate care, decided what is not now being done that could make the most difference to improve care and built the guideline around those issues. A focus group of primary care physicians reviewed the guideline draft and made suggestions. The guideline defines palliative care and its role in the trajectory of various life-limiting conditions, differentiating between palliative care and hospice care. It suggests trigger questions that providers can use, adapt and revisit throughout the progress of illness to address the major foci of palliative care. The project champion, Quality Life Institute both initiated the project and is serving as the primary implementation engine.