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Developing quality indicators for cancer end-of-life care†

Proceedings from a national symposium

  1. Hsien Seow PhD1,
  2. Claire F. Snyder PhD, MHS1,
  3. Lisa R. Shugarman PhD2,
  4. Richard A. Mularski MD, MSHS3,
  5. Jean S. Kutner MD, MSPH4,
  6. Karl A. Lorenz MD, MSHS5,
  7. Albert W. Wu MD, MPH1,
  8. Sydney M. Dy MD, MSc1,‡,*

Article first published online: 9 JUN 2009

DOI: 10.1002/cncr.24439

Issue

Cancer

Cancer

Volume 115, Issue 17, pages 3820–3829, 1 September 2009

Additional Information

How to Cite

Seow, H., Snyder, C. F., Shugarman, L. R., Mularski, R. A., Kutner, J. S., Lorenz, K. A., Wu, A. W. and Dy, S. M. (2009), Developing quality indicators for cancer end-of-life care. Cancer, 115: 3820–3829. doi: 10.1002/cncr.24439

Author Information

  1. 1

    Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

  2. 2

    RAND Corporation, Santa Monica, California

  3. 3

    The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon

  4. 4

    University of Colorado School of Medicine, Denver, Colorado

  5. 5

    Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California

  1. ‡

    Fax: (410) 955-0470

*624 N. Broadway, Rm 609, Baltimore, MD 21205

  1. †

    The Symposium on Developing a Framework to Assess Cancer Quality Indicators for End-of-life Care was held in Baltimore, Maryland, on April 28, 2008.

Publication History

  1. Issue published online: 20 AUG 2009
  2. Article first published online: 9 JUN 2009
  3. Manuscript Accepted: 20 JAN 2009
  4. Manuscript Revised: 13 JAN 2009
  5. Manuscript Received: 4 DEC 2008

Funded by

  • Agency for Healthcare Research and Quality. Grant Number: 290-2005-0034I
  • US Department of Health and Human Services
  • Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program

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Keywords:

  • care planning;
  • communication;
  • depression;
  • dyspnea;
  • end-of-life care;
  • pain;
  • psychosocial care;
  • quality indicators;
  • spirituality;
  • symptom assessment

Quality indicators applicable to cancer have not been widely implemented. To advance this field, the authors worked with the Agency for Health Care Research and Quality and the National Cancer Institute to organize a national symposium to discuss key issues and future goals, based on a conceptual framework.

Abstract

Quality indicators applicable to cancer end-of-life care exist, but have not been widely implemented. To advance this field, the authors worked with the Agency for Health Care Research and Quality and the National Cancer Institute to organize a national symposium to discuss key issues and future goals, based on a conceptual framework. Discussions focused on 8 key domains in end-of-life cancer care: pain; dyspnea; communication, care planning, and decision making; psychosocial care; communication about chemotherapy; depression; continuity, coordination, and care transitions; and spirituality and closure. Key themes included the need for clarity on definitions and key aspects of care within domains, the need to start implementing indicators in more developed domains, and the importance of high-quality symptom assessment and documentation of key processes. Key areas for future work include development of more outcome indicators, methods to better incorporate indicators and patient-reported outcomes into clinical processes of care, and coordination across domains and settings. Measuring the quality of end-of-life cancer care is essential to understanding how best to improve patient outcomes and care. Cancer 2009. © 2009 American Cancer Society.

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