Palliative Care and End-of-Life Care

This is a multi-item measure consisting of 4 items: Q1: “I felt heard and understood by this provider and team”, Q2: “I felt this provider and team put my best interests first when making recommendations about my care”, Q3: “I felt this provider and team saw me as a person, not just someone with a medical problem”, Q4: “I felt this provider and team understood what is important to me in my life.”

The percentage of patients aged 18 years and older who had an ambulatory palliative care visit and report getting the help they wanted for their pain from their palliative care provider and team within 6 months of the ambulatory palliative care visit.

Response to NQF request for clarification: 

This measure reflects the percentage of hospice patients with documentation of a discussion of spiritual/religious concerns or documentation that the patient/caregiver/family did not want to discuss.

The purpose of this measure is to assess families´ perceptions of the quality of care that Veterans received from the VA in the last month of life. The BFS consists of 19 items (17 structured and 2 open-ended). The BFS items were selected from a longer survey that was developed and validated with the support of a VA HSR&D Merit Award and have been approved for use by the Office of Management and Budget.

The measures submitted here are derived from the CAHPS® Hospice Survey, which is a 47-item standardized questionnaire and data collection methodology. The survey is intended to measure the care experiences of hospice patients and their primary caregivers. Respondents to the survey are the primary informal caregivers of patients who died under hospice care. These are typically family members but can be friends. The hospice identifies the primary informal caregiver from their administrative records.

Percentage of patients who report being uncomfortable because of pain at the initial assessment who, at the follow up assessment, report pain was brought to a comfortable level within 48 hours.

This measure reports the percentage of patients, regardless of age, with a diagnosis of painful bone metastases and no history of previous radiation who receive external beam radiation therapy (EBRT) with an acceptable fractionation scheme as defined by the guideline.

Derived from responses to 17 items on the Family Evaluation of Hospice Care(FEHC)survey presented as a single score ranging from 0 to 100 and is an indication of the hospice´s overall performance on key aspects of care delivery.

Percentage of hospice or palliative care patients who were screened for dyspnea during the hospice admission evaluation / palliative care initial encounter.

Percentage of patients who screened positive for dyspnea who received treatment within 24 hours of screening.