Study Creates Benchmarks for Evaluating Community-Based Palliative Care

Use of palliative care, an interdisciplinary approach to caring for individuals with life-limiting illness focused on improving quality of life, is increasing as our population ages and evidence about its benefits grows.  However, there is still little information about which care activities are necessary for delivering high-quality palliative care in the community.

A team led by Nrupen Bhavsar, PhD, MPH, of Duke’s division of general internal medicine and Donald H. Taylor, Jr, PhD, of the Duke Clinical Research Institute, Duke-Margolis and the Sanford School of Public Policy, worked with partners at Four Seasons Hospice organization to conduct a time and motion study at three care settings, resulting in a detailed process map. The team calculated the time spent on patient care, administrative duties, care coordination, and other activities.

“There is wide variation in how providers deliver palliative care,” said Taylor, “this study is the first step to designing incentives for high-value palliative care, including the development and sharing of best practices and generating evidence that can help us establish a value-based payment model.”

The study was published in the Journal of Palliative Medicine.  Other members of the research team include Janet Bull, MD, MBA of Four Seasons, and Kate Bloom, MPH, Jonathan Nicolla, MBA, Callie Gable, BA, Abby Goodman, BS, Andrew Olson, MPP, and Matthew Harker, MPH, MBA.  Olson and Harker are members of DCRI and Duke-Margolis.

Funding for this research was made possible, in part, by the Centers for Medicare & Medicaid Innovation through grant 1C1CMS331331.