The Common Sense Guide to Improving Palliative Care > Preface

Sick To Death book cover This extract from the online edition of The Common Sense Guide to Improving Palliative Care is used with permission.

The Common Sense Guide to Improving Palliative Care : Preface

This guide is for clinicians and managers hoping to improve the care that people living in the shadow of death can count on. This guide distills what we have learned from working with a few hundred clinical teams across the United States and abroad. With the pointers given here, nurses, physicians, or administrators can set about making their local care system into a reliably high-quality service to support seriously ill people and their families.

This short guide has a companion volume, Improving Care for the End of Life (Oxford University Press, rev. ed., 2007), which includes many more tools, improvement strategies, references, and narratives from specific teams making improvements in care for the last stages of life. We also recommend updated information from the U.S. Medicare quality-improvement projects (, from worldwide private efforts to improve health care quality (, from the Center to Advance Palliative Care (, and from our own work on quality improvement (

This book has had many supporters, and we are grateful to the clinical teams who have so generously taught us so much. We thank the RAND Corporation for providing a home to the Palliative Care Policy Center, both for our research endeavors and our quality improvement initiatives. We also want to thank the Kaiser Foundation Research Institute, the Dr. Sidney Garfield Memorial Fund, and Catholic Health Care West, California, for providing financial support to enable us to write the guide and to the Retirement Research Foundation and the Alfred P. Sloan Foundation for the support that first enabled us to write Improving Care for the End of Life. All who use rapid-cycle methods are indebted to the Institute for Healthcare Improvement for its vision of better care at the end of life. We thank Oxford University Press for the guidance that it has provided for this book and for its substantial commitment to publishing in palliative care. We thank the Quality and Access Division at the National Hospice and Palliative Care Organization and Diane Meier of the Center to Advance Palliative Care for their review of drafts of sections of this book. Finally, we thank Lisa Spear for attending to the details of preparing the manuscript and Les Morgan for revising it to appear on the Inter-Institutional Collaborating Network for Palliative Care, which is available online at many sites (including ( and Growth House (

Chapter 12 is based largely on the writings of Diane Meier, MD, FACP, Director of the Center to Advance Palliative Care at Mount Sinai School of Medicine, and Charles von Gunten, MD, PhD, FACP, Director of the Center for Palliative Studies, San Diego Hospice and Palliative Care (see also