Today, many organizations are working to improve end-of-life care, committed to ensuring that all patients and families experience a "good death," a comfortable and meaningful period of time while living with serious, eventually fatal illness. These organizations include the Last Acts campaign of the Robert Wood Johnson Foundation, the Education for Physicians on End-of-Life Care (EPEC) of the American Medical Association, hospices and their professional associations, Americans for Better Care of the Dying, and multiple programs sponsored by the Department of Veterans Affairs.
Improvement in end-of-life care will ultimately come from many areas, from many approaches to change, and from the joint efforts of biomedical researchers, policymakers, health care professionals, and the public. Many strategies, in addition to quality improvement activities, will lead to significant improvements in end of life care. For instance:
Most of us alive today will die late in life of chronic illness; we will turn to the health care system for information, care, and support. We will be fortunate to live long and to be relatively healthy for a long time. We know that the care system does not function well, that most dying patients and their families suffer at the end of life. And we have an unprecedented opportunity to improve that system, to make a difference in how people die - not only in the next decade, but in the next year. Such opportunities to make a difference are rare - and if we do not take it now, we will find ourselves dying in the very system we allowed to drift.
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.
For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].