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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
×

Building the Workforce
We Need to Care for
People with Serious Illness

PROCEEDINGS OF A WORKSHOP

Kaitlyn Friedman, Joe Alper, and Laurene Graig, Rapporteurs

Roundtable on Quality Care for People with Serious Illness

Board on Health Care Services

Board on Health Sciences Policy

Health and Medicine Division

images

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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This activity was supported by Contract No. HHSN2632018000029I (Task Order No. 75N98019F00851) with the National Institutes of Health’s National Institute of Nursing Research and by the American Academy of Hospice and Palliative Medicine, American Cancer Society, American Geriatrics Society, Anthem Inc., Ascension Health, Association of Professional Chaplains, Association of Rehabilitation Nurses, Blue Cross Blue Shield Association, Blue Cross Blue Shield of Arizona, Blue Cross Blue Shield of Massachusetts, Blue Cross Blue Shield of North Carolina, Bristol-Myers Squibb, The California State University Shiley Institute for Palliative Care, Cambia Health Solutions, Cedars-Sinai Health System, Center to Advance Palliative Care, Coalition to Transform Advanced Care, Excellus BlueCross BlueShield, Gordon and Betty Moore Foundation, The Greenwall Foundation, The John A. Hartford Foundation, Hospice & Palliative Nurses Association, Humana, Kaiser Permanente, National Coalition for Hospice and Palliative Care, National Hospice and Palliative Care Organization, National Palliative Care Research Center, National Patient Advocate Foundation, The New York Academy of Medicine, Oncology Nursing Society, Patient-Centered Outcomes Research Institute, Social Work Hospice & Palliative Care Network, Supportive Care Coalition, and the National Academy of Medicine.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2020. Building the workforce we need to care for people with serious illness: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25789.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

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For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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PLANNING COMMITTEE FOR BUILDING THE WORKFORCE WE NEED TO CARE FOR PEOPLE WITH SERIOUS ILLNESS: A WORKSHOP1

BRYNN BOWMAN (Co-Chair), Vice President for Education, Center to Advance Palliative Care

BRENDA NEVIDJON (Co-Chair), Chief Executive Officer, Oncology Nursing Society

JENNIFER BALLENTINE, Executive Director, The California State University Shiley Institute for Palliative Care

ROBERT A. BERGAMINI, Medical Director, Palliative Care Services, Mercy Clinic Children’s Cancer and Hematology, representing the Supportive Care Coalition

GRACE B. CAMPBELL, Assistant Professor, Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, representing the Association of Rehabilitation Nurses

CLESE ERIKSON, Deputy Director, Health Workforce Policy Research Center, The George Washington University

DENISE HESS, Executive Director, Supportive Care Coalition, representing the Association of Professional Chaplains

AMY MELNICK, Executive Director, National Coalition for Hospice and Palliative Care

JERI L. MILLER, Chief, Office of End-of-Life and Palliative Care Research, Senior Policy Analyst, National Institute of Nursing Research, National Institutes of Health

MIGUEL PANIAGUA, Medical Advisor, Solutions Design and Delivery, National Board of Medical Examiners, and Adjunct Professor of Medicine, Perelman School of Medicine, University of Pennsylvania

PHILIP A. PIZZO, Founding Director, Stanford Distinguished Careers Institute, Former Dean and David and Susan Heckerman Professor of Pediatrics and of Microbiology and Immunology, Stanford School of Medicine

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
×

JOANNE REIFSNYDER, Executive Vice President, Clinical Operations, and Chief Nursing Officer, Genesis Healthcare, representing the Hospice and Palliative Nurses Association

JOE ROTELLA, Chief Medical Officer, CatalystHPM, American Academy of Hospice and Palliative Medicine

TRACY SCHROEPFER, Professor, School of Social Work, University of Wisconsin

JOSEPH W. SHEGA, Regional Medical Director, VITAS Hospice Care, representing the American Geriatrics Society

JOAN WEISS, Chief, Geriatrics and Allied Health Branch, Health Resources and Services Administration

Project Staff

LAURENE GRAIG, Director, Roundtable on Quality Care for People with Serious Illness

KAITLYN FRIEDMAN, Research Associate

RUHAMA GARI, Senior Program Assistant (from October 2019 to February 2020)

SHARYL NASS, Senior Director, Board on Health Care Services, and Director, National Cancer Policy Forum

ANDREW M. POPE, Senior Director, Board on Health Sciences Policy

Consultant

JOE ALPER, Consulting Writer

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
×

ROUNDTABLE ON QUALITY CARE FOR PEOPLE WITH SERIOUS ILLNESS1

LEONARD D. SCHAEFFER (Chair), Judge Robert Maclay Widney Chair and Professor, University of Southern California

JAMES A. TULSKY (Vice Chair), Chair, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute; Chief, Division of Palliative Medicine, Brigham and Women’s Hospital; Professor of Medicine and Co-Director, Center for Palliative Care, Harvard Medical School

KIRK ALLEN, President, Humana at Home, Humana

JENNIFER BALLENTINE, Executive Director, The California State University Shiley Institute for Palliative Care

ROBERT A. BERGAMINI, Medical Director, Palliative Care Services, Mercy Clinic Children’s Cancer and Hematology, representing the Supportive Care Coalition

LORI BISHOP, Vice President of Palliative and Advanced Care, National Hospice and Palliative Care Organization

PATRICIA A. BOMBA, Vice President and Medical Director, Excellus BlueCross BlueShield; Chair, MOLST Statewide Implementation Team; Chair, National Healthcare Decisions Day, New York States Coalition

GRACE B. CAMPBELL, Assistant Professor, Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, representing the Association of Rehabilitation Nurses

JANE CARMODY, Program Officer, The John A. Hartford Foundation

STEVE CLAUSER, Director, Healthcare Delivery and Disparities Research Program, Patient-Centered Outcomes Research Institute

DAVID J. DEBONO, Medical Director for Oncology, Anthem Inc.

CHRISTOPHER M. DEZII, Lead, Quality and Measure Development, State and Federal Payment Agencies, U.S. Value, Access and Payment, Bristol-Myers Squibb

ANDREW DREYFUS, President and Chief Executive Officer, Blue Cross Blue Shield of Massachusetts

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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CAROLE REDDING FLAMM, Executive Medical Director, Blue Cross Blue Shield Association

MARK B. GANZ, President and Chief Executive Officer, Cambia Health Solutions

DENISE HESS, Executive Director, Supportive Care Coalition, representing the Association of Professional Chaplains

PAMELA S. HINDS, Director and Professor, Conway Chair in Nursing Research; Director, Nursing Research and Quality Outcomes, Children’s National Health System

HAIDEN HUSKAMP, 30th Anniversary Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School

KIMBERLY SHERELL JOHNSON, Associate Professor of Medicine, Senior Fellow in the Center of Aging and Human Development, Duke University School of Medicine

REBECCA A. KIRCH, Executive Vice President of Healthcare Quality and Value, National Patient Advocate Foundation

TOM KOUTSOUMPAS, Cofounder, Coalition to Transform Advanced Care; President and Chief Executive Officer, National Partnership for Hospice Innovation

SHARI M. LING, Deputy Chief Medical Officer, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services

BERNARD LO, President and Chief Executive Officer, The Greenwall Foundation

DIANE E. MEIER, Director, Center to Advance Palliative Care; Gaisman Professor of Medical Ethics, Vice Chair for the Public Policy and Professor, Icahn School of Medicine at Mount Sinai

AMY MELNICK, Executive Director, National Coalition for Hospice and Palliative Care

JERI L. MILLER, Chief, Office of End-of-Life and Palliative Care Research, Senior Policy Analyst, National Institute of Nursing Research, National Institutes of Health

R. SEAN MORRISON, Co-Director, Patty and Jay Baker National Palliative Care Center; Director, National Palliative Care Research Center; Director, Hertzberg Palliative Care Institute; Professor of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai

BRENDA NEVIDJON, Chief Executive Officer, Oncology Nursing Society

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
×

JUDITH R. PERES, Long-Term and Palliative Care Consultant, Clinical Social Worker and Board Member, Social Work Hospice and Palliative Care Network

PHILIP A. PIZZO, Founding Director, Stanford Distinguished Careers Institute, Former Dean and David and Susan Heckerman Professor of Pediatrics and of Microbiology and Immunology, Stanford School of Medicine

THOMAS M. PRISELAC, President and Chief Executive Officer, Cedars-Sinai Health System

KITTY PURINGTON, Senior Program Director, National Academy for State Health Policy

RUBINA RAJA, Medical Director Operations, Blue Cross Blue Shield of Arizona

RAHUL RAJKUMAR, Senior Vice President and Chief Medical Officer, Blue Cross Blue Shield of North Carolina

JOANNE REIFSNYDER, Executive Vice President, Clinical Operations, and Chief Nursing Officer, Genesis Healthcare, representing the Hospice and Palliative Nurses Association

JOE ROTELLA, Chief Medical Officer, CatalystHPM, American Academy of Hospice and Palliative Medicine

JUDITH A. SALERNO, President, The New York Academy of Medicine, Senior Vice President, Patient and Caregiver Support, American Cancer Society

JOSEPH W. SHEGA, Regional Medical Director, VITAS Hospice Care, representing the American Geriatrics Society

SUSAN ELIZABETH WANG, Regional Lead for Shared Decision-Making and Advance Care Planning, Southern California Permanente Medical Group, Kaiser Permanente

DAWN WIATREK, Director, Public Health Strategy, American Cancer Society

BALIGH YEHIA, Chief Medical Officer, Ascension Health

Roundtable on Quality Care for People with Serious Illness Staff

LAURENE GRAIG, Director, Roundtable on Quality Care for People with Serious Illness

KAITLYN FRIEDMAN, Research Associate

RUHAMA GARI, Senior Program Assistant (from October 2019 to February 2020)

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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ANESIA WILKS, Senior Program Assistant (as of March 2020)

MICAH WINOGRAD, Senior Financial Business Partner

SHARYL NASS, Senior Director, Board on Health Care Services, and Director, National Cancer Policy Forum

ANDREW M. POPE, Senior Director, Board on Health Sciences Policy

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
×

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by MARK LAZENBY, Yale School of Nursing. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Acknowledgments

The National Academies of Sciences, Engineering, and Medicine’s Roundtable on Quality Care for People with Serious Illness wishes to express its sincere gratitude to the Planning Committee Co-Chairs Brynn Bowman and Brenda Nevidjon for their valuable contributions to the development and organization of this workshop. The roundtable also wishes to thank all of the members of the planning committee, who collaborated to ensure a workshop complete with informative presentations and rich discussions. Finally, the roundtable wants to thank the speakers and moderators, who generously shared their expertise and their time with workshop participants.

Support from the many annual sponsors of the roundtable is critical to its work. The sponsors include the American Academy of Hospice and Palliative Medicine, American Cancer Society, American Geriatrics Society, Anthem Inc., Ascension Health, Association of Professional Chaplains, Association of Rehabilitation Nurses, Blue Cross Blue Shield Association, Blue Cross Blue Shield of Arizona, Blue Cross Blue Shield of Massachusetts, Blue Cross Blue Shield of North Carolina, Bristol-Myers Squibb, The California State University Shiley Institute for Palliative Care, Cambia Health Solutions, Cedars-Sinai Health System, Center to Advance Palliative Care, Coalition to Transform Advanced Care, Excellus BlueCross BlueShield, Gordon and Betty Moore Foundation, The Greenwall Foundation, The John A. Hartford Foundation, Hospice & Palliative Nurses Association, Humana, Kaiser Permanente, National Coalition for Hospice and Pal-

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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liative Care, National Hospice and Palliative Care Organization, National Institute of Nursing Research, National Palliative Care Research Center, National Patient Advocate Foundation, The New York Academy of Medicine, Oncology Nursing Society, Patient-Centered Outcomes Research Institute, Social Work Hospice & Palliative Care Network, Supportive Care Coalition, and the National Academy of Medicine.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Acronyms and Abbreviations

AACN American Association of Colleges of Nursing
ACGME Accreditation Council for Graduate Medical Education
AHA American Hospital Association
APRN advanced practice registered nurse
BLS Bureau of Labor Statistics
CAPC Center to Advance Palliative Care
CEO chief executive officer
CMS Centers for Medicare & Medicaid Services
CSU California State University
ELNEC End-of-Life Nursing Education Consortium
GACA Geriatrics Academic Career Award
GWEP Geriatric Workforce Enhancement Program
HHS Department of Health and Human Services
HRSA Health Resources and Services Administration
iCOPE Interdisciplinary Curriculum for Oncology Palliative Education
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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IOM Institute of Medicine
iPEX InterProfessional Education eXchange program
NCHWA National Center for Health Workforce Analysis
NCI National Cancer Institute
NCP National Consensus Project
NP nurse practitioner
PA physician assistant
PCHETA Palliative Care and Hospice Education and Training Act
RN registered nurse
UCSF University of California, San Francisco
VA Department of Veterans Affairs
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Building the Workforce We Need to Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25789.
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The United States faces a significantly aging population as well as a growing share of the population that is living longer with multiple chronic conditions. To provide high-quality care to people of all ages living with serious illness, it is critical that the nation develop an adequately trained and prepared workforce consisting of a range of professionals, including physicians, nurses, social workers, direct care workers, and chaplains. To explore some of the key workforce-related challenges to meeting the needs of people with serious illness, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on November 7, 2019. This publication summarizes the presentations and discussions from the workshop.

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