ABCD Exchange : January 1998 : Resources - IOM Report : Approaching Death

Institute of Medicine Suggests Strengthening Knowledge Base
by Joanne Lynn, M.D.

The IOM urges America's research establishment, to "define and implement priorities for strengthening the knowledge base for end-of-life care." The report recommends that research organizations:

• Encourage the collection of more information on the quality of life for people who die while enrolled in clinical trials.

• Study the physiological mechanisms and treatment of symptoms common during the end of life.

• Develop pathways to improve dissemination and replication of effective interventions and programs.

Better information systems and tools for measuring outcomes and evaluating care are critical to creating effective and accountable systems of care. The IOM recommends that policymakers, consumer groups, and purchasers of health care work with health care providers and researchers to:

• Strengthen methods for measuring the quality of life and other outcomes of care;

• Develop better tools and strategies for improving the quality of care and holding health care organizations accountable for care at the end of life;

• Revise mechanisms for financing care so that they encourage good end-of-life care, and sustain coordinated systems of excellent care; and,

• Reform drug prescription laws, burdensome regulations, and state medical board policies and practices that impede effective use of opioids to relieve pain and suffering.

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