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Part 1: Executive Summary
Pages 1-8

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From page 3... ... Improvements in the development and delivery of symptom control and other aspects of palliative care needed in the late stages of cancer (and other chronic diseases) have not kept pace with the medical advances that have allowed people to live longer. Read the entire page →
From page 4... ... Barriers to Excellent Palliative and End-of-Life Care Barriers throughout the health care and medical research systems stand in the way of many people receiving effective palliative care where and when they need it. These barriers include the following: � the separation of palliative and hospice care from potentially lifeprolonging treatment within the health care system, which is both influenced by and affects reimbursement policy; � inadequate training of health care personnel in symptom management and other end-of-life care skills; � inadequate standards of care and lack of accountability in caring for dying patients; � disparities in care, even when available, for African Americans and other ethnic and socioeconomic segments of the population; � lack of information resources for the public dealing with palliative and end-of-life care; � lack of reliable data on the quality of life, and the quality of care of patients dying from cancer (as well as other chronic diseases) Read the entire page →
From page 5... ... -designated cancer centers, contains elements that address all the barriers. NCI-designated cancer centers should play a central role as agents of national policy in advancing palliative care research and clinical practice, with initiatives that address many of the barriers identified in this report. Read the entire page →
From page 6... ... Activities should include, but not be limited to the following: � ford testing and evaluation of new and existing practice guidelines for palliative and end-of-life care; � pilot testing "quality indicators" for assessing end-of-life care at the level of the patient and the institution; � incorporating the best palliative care into NCI-sponsored clinical trials; � innovating in the delivery of palliative and end-of-life care, including colIaboration with local hospice organizations; � disseminating infor~nation about how to improve end-of-life care to other cancer centers and hospitals through ~ variety of media; � uncovering the deter~ninants of disparities in access to care by minority populations that should be served by the center, and developing specific programs and initiatives to increase access; these might include educational activities for health care providers and the community, setting up outreach programs, etc.; � providing clinical and research training fellowships in medical and surgical oncology in end-of-life care for adult and pediatric patients; � creating faculty development programs in oncology, nursing, undo social work; and � Providing in-service training for local hospice staff in new palliative care techniques. Recommendation 2: NCI should add the requirement of research in palliative care and symptom control for recognition as ~ "Comprehensive Cancer Center." Practices and policies that govern payment for palliative care (in both public and private sectors) Read the entire page →
From page 7... ... Recommendation 7: The recommendations in the NCPB report, Enhancing Data Systems to Improve the Quality of Cancer Care (see Appendix BJ should be applied equally to palliative and end-of-life care as to other aspects of cancer treatment. These recommendations include � developing ~ core set of cancer care quality measures; � increasing public undo private support for cancer registries; � supporting research undo demonstration projects to identify new mechanisms to organize and finance the collection of data for cancer care quality studies; Read the entire page →
From page 8... ... Recommendation 10: NCI should review the membership of its advisory bodies to ensure representation of experts in cancer pain, symptom management, undo palliative care. lIn 1999, NCI initiated State of the Science Meetings focused on specific types of cancer "to bring together the Nation's leading multidisciplinary experts, to identify the important research questions for a given disease and help define the scientific research agenda that will assist us in addressing those questions." Read the entire page →

From page 1...

... Part 1

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From page 3...

... Improvements in the development and delivery of symptom control and other aspects of palliative care needed in the late stages of cancer (and other chronic diseases) have not kept pace with the medical advances that have allowed people to live longer.

Read the entire page →

From page 4...

... Barriers to Excellent Palliative and End-of-Life Care Barriers throughout the health care and medical research systems stand in the way of many people receiving effective palliative care where and when they need it. These barriers include the following: � the separation of palliative and hospice care from potentially lifeprolonging treatment within the health care system, which is both influenced by and affects reimbursement policy; � inadequate training of health care personnel in symptom management and other end-of-life care skills; � inadequate standards of care and lack of accountability in caring for dying patients; � disparities in care, even when available, for African Americans and other ethnic and socioeconomic segments of the population; � lack of information resources for the public dealing with palliative and end-of-life care; � lack of reliable data on the quality of life, and the quality of care of patients dying from cancer (as well as other chronic diseases)

Read the entire page →

From page 5...

... -designated cancer centers, contains elements that address all the barriers. NCI-designated cancer centers should play a central role as agents of national policy in advancing palliative care research and clinical practice, with initiatives that address many of the barriers identified in this report.

Read the entire page →

From page 6...

... Activities should include, but not be limited to the following: � ford testing and evaluation of new and existing practice guidelines for palliative and end-of-life care; � pilot testing "quality indicators" for assessing end-of-life care at the level of the patient and the institution; � incorporating the best palliative care into NCI-sponsored clinical trials; � innovating in the delivery of palliative and end-of-life care, including colIaboration with local hospice organizations; � disseminating infor~nation about how to improve end-of-life care to other cancer centers and hospitals through ~ variety of media; � uncovering the deter~ninants of disparities in access to care by minority populations that should be served by the center, and developing specific programs and initiatives to increase access; these might include educational activities for health care providers and the community, setting up outreach programs, etc.; � providing clinical and research training fellowships in medical and surgical oncology in end-of-life care for adult and pediatric patients; � creating faculty development programs in oncology, nursing, undo social work; and � Providing in-service training for local hospice staff in new palliative care techniques. Recommendation 2: NCI should add the requirement of research in palliative care and symptom control for recognition as ~ "Comprehensive Cancer Center." Practices and policies that govern payment for palliative care (in both public and private sectors)

Read the entire page →

From page 7...

... Recommendation 7: The recommendations in the NCPB report, Enhancing Data Systems to Improve the Quality of Cancer Care (see Appendix BJ should be applied equally to palliative and end-of-life care as to other aspects of cancer treatment. These recommendations include � developing ~ core set of cancer care quality measures; � increasing public undo private support for cancer registries; � supporting research undo demonstration projects to identify new mechanisms to organize and finance the collection of data for cancer care quality studies;

Read the entire page →

From page 8...

... Recommendation 10: NCI should review the membership of its advisory bodies to ensure representation of experts in cancer pain, symptom management, undo palliative care. lIn 1999, NCI initiated State of the Science Meetings focused on specific types of cancer "to bring together the Nation's leading multidisciplinary experts, to identify the important research questions for a given disease and help define the scientific research agenda that will assist us in addressing those questions."

Read the entire page →

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Part 1: Executive Summary Pages 1-8

Part 1: Executive Summary
Pages 1-8