Abstract
The quality of hospice care remains highly variable in the U.S. Patients, providers,
and health care systems lack a comprehensive method of measuring the quality of care
provided by an individual hospice. Partners HealthCare sought to assess hospice quality
based on objective and quantitative criteria obtained directly from hospices and through
public reporting. Here, we describe the process of creating and administering this
assessment and the initial creation of a collaborative network with high-quality hospices.
A multidisciplinary advisory council developed criteria and a scoring system, focusing
on organizational information (e.g., nursing turnover), clinical care quality indicators
(e.g., visit hours before death), and training (e.g., medical director certification)
and satisfaction (e.g., patient and family surveys). All Medicare-certified hospices
in good standing in Massachusetts were eligible to participate in a request for information
(RFI) process. We blinded data before scoring and invited hospices scoring above the
15th percentile to join the initial collaborative.
Of 72 eligible hospices, most (53%) responded to the RFI, and 32% (n = 23) submitted completed surveys. Hospices could receive up to 23.75 points, and
scores ranged from 2.25 to 19.5. The median score was 13.62 (interquartile range 10.5–16.75).
For hospices scoring above the 15th percentile (n = 19), scores ranged from 10.0 to 19.5 (median 14).
The hospice RFI process is one health care system's attempt to evaluate hospice quality.
Further research will determine whether the scoring system proves to be a sensitive,
specific, and reproducible measure of hospice quality, and whether the collaborative
can foster quality improvement over time.
Key Words
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Article info
Publication history
Published online: June 05, 2020
Accepted:
May 29,
2020
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.
