The 130th Annual Meeting of APHA

Abstract #38230

Sarah Staff Myers, MPH, Center to Improve Care of the Dying, RAND, 1200 South Hayes Road, Arlington, VA 22202 and Deborah E. Halper, MPH/MSUP, United Hospital Fund, 350 Fifth Avenue, New York, NY 10118, 2124949737, smyers@rand.org.

Patients nearing the end of life with serious, chronic illness face a health care system that is ill equipped to meet their myriad needs. The RAND Center to Improve Care of the Dying is working with the United Hospital Fund and other partners in several cities to help local providers apply rapid-cycle quality improvement to improving care for this population. Teams from hospitals, nursing homes, hospices, and home health agencies are working together through quality improvement Collaboratives in New York City, Pittsburgh, and soon, Washington, DC. They seek to make rapid, measurable improvements in advance care planning, pain management, continuity, and patient/family support. The Model for Improvement used in Collaboratives gives teams a method for setting aims for improved care, developing measures by which to track their progress, and selecting changes to test on a small scale to determine whether they lead to improvement. In past Collaboratives, teams achieved such improvements as a 60% reduction in patients with pain greater than 5 on a 10-point scale and a 50% or greater increase in documentation of advance care plans. Subsequent Collaboratives will bring improved care to many more individuals, thereby addressing the needs of this vulnerable, growing segment of the population. Target Audiences: Clinicians and managers who serve populations nearing the end of life with serious, chronic illness

Learning Objectives: