The Experts below are selected from a list of 57831 Experts worldwide ranked by ideXlab platform
Elizabeth H. Bradley - One of the best experts on this subject based on the ideXlab platform.
-
Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment.
Journal of pain and symptom management, 2016Co-Authors: Shi-yi Wang, Emily Cherlin, Melissa D Aldridge, Maureen Canavan, Elizabeth H. BradleyAbstract:Abstract Context Among the four levels of Hospice care, continuous home care (CHC) is the most expensive care, and infrequently provided in practice. Objectives To identify Hospice and patient characteristics associated with the use of CHC and to examine the associations between CHC utilization and Hospice disenrollment or hospitalization after Hospice enrollment. Methods Using 100% fee-for-service Medicare claims data for beneficiaries aged 66 years or older who died between July and December 2011, we identified the percentage of Hospice agencies in which patients used CHC in 2011 and determined Hospice and patient characteristics associated with the use of CHC. Using multivariable analyses, we examined the associations between CHC utilization and Hospice disenrollment and hospitalization after Hospice enrollment, adjusted for Hospice and patient characteristics. Results Only 42.7% of Hospices (1533 of 3592 Hospices studied) provided CHC to at least one patient during the study period. Patients enrolled with for-profit, larger, and urban located Hospices were more likely to use CHC (P Conclusion Although a minority of patients uses CHC, such services may be protective against Hospice disenrollment and hospitalization after Hospice enrollment.
-
massage music and art therapy in Hospice results of a national survey
Journal of Pain and Symptom Management, 2015Co-Authors: Aleksandra S Dain, Elizabeth H. Bradley, Rosemary Hurzeler, Melissa D AldridgeAbstract:Abstract Context Complementary and alternative medicine (CAM) provides clinical benefits to Hospice patients, including decreased pain and improved quality of life. Yet little is known about the extent to which U.S. Hospices employ CAM therapists. Objectives To report the most recent national data regarding the inclusion of art, massage, and music therapists on Hospice interdisciplinary teams and how CAM therapist staffing varies by Hospice characteristics. Methods A national cross-sectional survey of a random sample of Hospices ( n = 591; 84% response rate) from September 2008 to November 2009. Results Twenty-nine percent of Hospices (169 of 591) reported employing an art, massage, or music therapist. Of those Hospices, 74% employed a massage therapist, 53% a music therapist, and 22% an art therapist, and 42% expected the therapist to attend interdisciplinary staff meetings, indicating a significant role for these therapists on the patient's care team. In adjusted analyses, larger Hospices compared with smaller Hospices had significantly higher odds of employing a CAM therapist (adjusted odds ratio 6.38; 95% CI 3.40, 11.99) and for-profit Hospices had lower odds of employing a CAM therapist compared with nonprofit Hospices (adjusted odds ratio 0.52; 95% CI 0.32, 0.85). Forty-four percent of Hospices in the Mountain/Pacific region reported employing a CAM therapist vs. 17% in the South Central region. Conclusion Less than one-third of U.S. Hospices employ art, massage, or music therapists despite the benefits these services may provide to patients and families. A higher proportion of large Hospices, nonprofit Hospices, and Hospices in the Mountain/Pacific region employ CAM therapists, indicating differential access to these important services.
-
national Hospice survey results for profit status community engagement and service
JAMA Internal Medicine, 2014Co-Authors: Melissa D Aldridge, Ruth Mccorkle, Colleen L Barry, Mark Schlesinger, Sean R Morrison, Rosemary Hurzeler, Elizabeth H. BradleyAbstract:Importance The impact of the substantial growth in for-profit Hospices in the United States on quality and Hospice access has been intensely debated, yet little is known about how for-profit and nonprofit Hospices differ in activities beyond service delivery. Objective To determine the association between Hospice ownership and (1) provision of community benefits, (2) setting and timing of the Hospice population served, and (3) community outreach. Design, Setting, and Participants Cross-sectional survey (the National Hospice Survey), conducted from September 2008 through November 2009, of a national random sample of 591 Medicare-certified Hospices operating throughout the United States. Exposures For-profit or nonprofit Hospice ownership. Main Outcomes and Measures Provision of community benefits; setting and timing of the Hospice population served; and community outreach. Results A total of 591 Hospices completed our survey (84% response rate). For-profit Hospices were less likely than nonprofit Hospices to provide community benefits including serving as training sites (55% vs 82%; adjusted relative risk [ARR], 0.67 [95% CI, 0.59-0.76]), conducting research (18% vs 23%; ARR, 0.67 [95% CI, 0.46-0.99]), and providing charity care (80% vs 82%; ARR, 0.88 [95% CI, 0.80-0.96]). For-profit compared with nonprofit Hospices cared for a larger proportion of patients with longer expected Hospice stays including those in nursing homes (30% vs 25%; P = .009). For-profit Hospices were more likely to exceed Medicare’s aggregate annual cap (22% vs 4%; ARR, 3.66 [95% CI, 2.02-6.63]) and had a higher patient disenrollment rate (10% vs 6%; P Conclusions and Relevance Ownership-related differences are apparent among Hospices in community benefits, population served, and community outreach. Although Medicare’s aggregate annual cap may curb the incentive to focus on long-stay Hospice patients, additional regulatory measures such as public reporting of Hospice disenrollment rates should be considered as the share of for-profit Hospices in the United States continues to increase.
-
Hospice for nursing home residents does ownership type matter
Journal of Palliative Medicine, 2013Co-Authors: Maureen Canavan, Melissa D.a. Carlson, Heather Sipsma, Elizabeth H. BradleyAbstract:Abstract Background: Currently, more than half of all nursing home residents use Hospice at some point. Studies have shown benefits to Hospice enrollment for patients; however, the literature on ownership differences in Hospice care in general has indicated that for-profit Hospices offer a narrower scope of services and employ fewer professional staff. Although nursing home staffing patterns have been shown to be essential to quality of care, the literature has not explored differences in number of patients per staff member for Hospice care within nursing homes. Methods: We hypothesized that for-profit Hospices would have a higher number of patients per staff member for home care workers (HCWs), registered nurses (RNs), and medical social workers (MSWs), and this relationship would be moderated by the proportion of Hospice users living in nursing homes. Using data from the National Hospice Survey, a random sampling of all Medicare-certified Hospices operating between September 2008 and November 2009, we i...
-
Hospices enrollment policies may contribute to underuse of Hospice care in the united states
Health Affairs, 2012Co-Authors: Melissa D.a. Carlson, Emily Cherlin, Ruth Mccorkle, Colleen L Barry, Elizabeth H. BradleyAbstract:Hospice use in the United States is growing, but little is known about barriers that terminally ill patients may face when trying to access Hospice care. This article reports the results of the first national survey of the enrollment policies of 591 US Hospices. The survey revealed that 78 percent of Hospices had at least one enrollment policy that may restrict access to care for patients with potentially high-cost medical care needs, such as chemotherapy or total parenteral nutrition. Smaller Hospices, for-profit Hospices, and Hospices in certain regions of the country consistently reported more limited enrollment policies. We observe that Hospice providers’ own enrollment decisions may be an important contributor to previously observed underuse of Hospice by patients and families. Policy changes that should be considered include increasing the Medicare Hospice per diem rate for patients with complex needs, which could enable more Hospices to expand enrollment.
Melissa D Aldridge - One of the best experts on this subject based on the ideXlab platform.
-
Have Hospice Costs Increased After Implementation of the Hospice Quality-Reporting Program?
Journal of pain and symptom management, 2019Co-Authors: Nan Tracy Zheng, Dana B. Mukamel, Franziska S. Rokoske, Melissa Morley, Samantha Zepeda, Melissa D AldridgeAbstract:Abstract Context The Centers for Medicare & Medicaid Services Hospice Quality–Reporting Program introduced the requirement that Hospices nationwide begin collecting and submitting standardized patient-level quality data on July 1, 2014. Objectives This study examined whether this requirement has increased Hospice total costs, general costs, and visiting services costs. Methods We conducted a cross-sectional study using data from the 2012 and 2014 Medicare Hospice cost reports linked to Hospice claims. We measured total costs per patient day (PPD), general costs PPD, and visiting services costs PPD for freestanding Hospices. We estimated the incremental costs of operating in 2014 vs. 2012 using hierarchical random effects models and adjusting for year, wage index, care volume, case-mix, and Hospice and market characteristics, stratified by Hospice ownership type. Results Both for-profit and nonprofit Hospices reported higher total costs PPD and general services costs PPD in 2014 than 2012. Nonprofit Hospices also reported higher general costs PPD in 2014 than 2012. In adjusted models, the total costs PPD in 2014 were $10.55 higher than in 2012 for nonprofit Hospices and $6.43 higher for for-profit Hospices. The increase in general costs PPD and visiting services costs PPD ranged from $3.15 to $5.87 by ownership and type of costs. Both for-profit and nonprofit Hospices showed lower costs PPD for all types associated with more patients and longer length of stay. Conclusion Hospice costs increased after the Centers for Medicare & Medicaid Services Hospice Quality–Reporting Program quality data collection/submission requirement. Complementary studies need to understand whether increased costs brought additional benefits.
-
Racial Disparities in Hospice Outcomes: A Race or Hospice-Level Effect?
Journal of the American Geriatrics Society, 2017Co-Authors: Jessica Rizzuto, Melissa D AldridgeAbstract:Objectives To determine whether there is racial variation in Hospice enrollees in rates of hospitalization and Hospice disenrollment and, if so, whether systematic differences in Hospice provider patterns explain the variation. Design Longitudinal cohort study. Setting Hospice. Participants Medicare beneficiaries (N = 145,038) enrolled in a national random sample of Hospices (N = 577) from the National Hospice Survey and followed until death (2009–10). Measurements We used Medicare claims data to identify hospital admissions, emergency department (ED) visits, and Hospice disenrollment after Hospice enrollment. We used a series of hierarchical models including Hospice‐level random effects to compare outcomes of blacks and whites. Results In unadjusted models, black Hospice enrollees were significantly more likely than white enrollees to be admitted to the hospital (14.9% vs 8.7%, odds ratio (OR) = 1.84, 95% confidence interval (CI) = 1.74–1.95), visit the ED (19.8% vs 13.5%, OR = 1.58, 95% CI = 1.50–1.66), and disenroll from Hospice (18.1% vs 13.0%, OR = 1.48, 95% CI = 1.40–1.56). These results were largely unchanged after accounting for participant clinical and demographic covariates and Hospice‐level random effects. In adjusted models, blacks were at higher risk of hospital admission (OR = 1.75, 95% CI = 1.64–1.86), ED visits (OR = 1.61, 95% CI = 1.52–1.70), and Hospice disenrollment (OR = 1.54, 95% CI = 1.45–1.63). Conclusion Racial differences in intensity of care at the end of life are not attributable to Hospice‐level variation in intensity of care. Differences in patterns of care between black and white Hospice enrollees persist within the same Hospice.
-
Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment.
Journal of pain and symptom management, 2016Co-Authors: Shi-yi Wang, Emily Cherlin, Melissa D Aldridge, Maureen Canavan, Elizabeth H. BradleyAbstract:Abstract Context Among the four levels of Hospice care, continuous home care (CHC) is the most expensive care, and infrequently provided in practice. Objectives To identify Hospice and patient characteristics associated with the use of CHC and to examine the associations between CHC utilization and Hospice disenrollment or hospitalization after Hospice enrollment. Methods Using 100% fee-for-service Medicare claims data for beneficiaries aged 66 years or older who died between July and December 2011, we identified the percentage of Hospice agencies in which patients used CHC in 2011 and determined Hospice and patient characteristics associated with the use of CHC. Using multivariable analyses, we examined the associations between CHC utilization and Hospice disenrollment and hospitalization after Hospice enrollment, adjusted for Hospice and patient characteristics. Results Only 42.7% of Hospices (1533 of 3592 Hospices studied) provided CHC to at least one patient during the study period. Patients enrolled with for-profit, larger, and urban located Hospices were more likely to use CHC (P Conclusion Although a minority of patients uses CHC, such services may be protective against Hospice disenrollment and hospitalization after Hospice enrollment.
-
massage music and art therapy in Hospice results of a national survey
Journal of Pain and Symptom Management, 2015Co-Authors: Aleksandra S Dain, Elizabeth H. Bradley, Rosemary Hurzeler, Melissa D AldridgeAbstract:Abstract Context Complementary and alternative medicine (CAM) provides clinical benefits to Hospice patients, including decreased pain and improved quality of life. Yet little is known about the extent to which U.S. Hospices employ CAM therapists. Objectives To report the most recent national data regarding the inclusion of art, massage, and music therapists on Hospice interdisciplinary teams and how CAM therapist staffing varies by Hospice characteristics. Methods A national cross-sectional survey of a random sample of Hospices ( n = 591; 84% response rate) from September 2008 to November 2009. Results Twenty-nine percent of Hospices (169 of 591) reported employing an art, massage, or music therapist. Of those Hospices, 74% employed a massage therapist, 53% a music therapist, and 22% an art therapist, and 42% expected the therapist to attend interdisciplinary staff meetings, indicating a significant role for these therapists on the patient's care team. In adjusted analyses, larger Hospices compared with smaller Hospices had significantly higher odds of employing a CAM therapist (adjusted odds ratio 6.38; 95% CI 3.40, 11.99) and for-profit Hospices had lower odds of employing a CAM therapist compared with nonprofit Hospices (adjusted odds ratio 0.52; 95% CI 0.32, 0.85). Forty-four percent of Hospices in the Mountain/Pacific region reported employing a CAM therapist vs. 17% in the South Central region. Conclusion Less than one-third of U.S. Hospices employ art, massage, or music therapists despite the benefits these services may provide to patients and families. A higher proportion of large Hospices, nonprofit Hospices, and Hospices in the Mountain/Pacific region employ CAM therapists, indicating differential access to these important services.
-
national Hospice survey results for profit status community engagement and service
JAMA Internal Medicine, 2014Co-Authors: Melissa D Aldridge, Ruth Mccorkle, Colleen L Barry, Mark Schlesinger, Sean R Morrison, Rosemary Hurzeler, Elizabeth H. BradleyAbstract:Importance The impact of the substantial growth in for-profit Hospices in the United States on quality and Hospice access has been intensely debated, yet little is known about how for-profit and nonprofit Hospices differ in activities beyond service delivery. Objective To determine the association between Hospice ownership and (1) provision of community benefits, (2) setting and timing of the Hospice population served, and (3) community outreach. Design, Setting, and Participants Cross-sectional survey (the National Hospice Survey), conducted from September 2008 through November 2009, of a national random sample of 591 Medicare-certified Hospices operating throughout the United States. Exposures For-profit or nonprofit Hospice ownership. Main Outcomes and Measures Provision of community benefits; setting and timing of the Hospice population served; and community outreach. Results A total of 591 Hospices completed our survey (84% response rate). For-profit Hospices were less likely than nonprofit Hospices to provide community benefits including serving as training sites (55% vs 82%; adjusted relative risk [ARR], 0.67 [95% CI, 0.59-0.76]), conducting research (18% vs 23%; ARR, 0.67 [95% CI, 0.46-0.99]), and providing charity care (80% vs 82%; ARR, 0.88 [95% CI, 0.80-0.96]). For-profit compared with nonprofit Hospices cared for a larger proportion of patients with longer expected Hospice stays including those in nursing homes (30% vs 25%; P = .009). For-profit Hospices were more likely to exceed Medicare’s aggregate annual cap (22% vs 4%; ARR, 3.66 [95% CI, 2.02-6.63]) and had a higher patient disenrollment rate (10% vs 6%; P Conclusions and Relevance Ownership-related differences are apparent among Hospices in community benefits, population served, and community outreach. Although Medicare’s aggregate annual cap may curb the incentive to focus on long-stay Hospice patients, additional regulatory measures such as public reporting of Hospice disenrollment rates should be considered as the share of for-profit Hospices in the United States continues to increase.
Debra Parker Oliver - One of the best experts on this subject based on the ideXlab platform.
-
results from the national Hospice volunteer training survey
Journal of Palliative Medicine, 2010Co-Authors: Elaine Wittenberglyles, Greg Schneider, Debra Parker OliverAbstract:Abstract Background: Although the role of volunteers is at the heart of Hospice care, little is known about Hospice volunteer training and volunteer activity. Method: A survey was used to assess current training programs for Hospice volunteers. Hospices were invited to participate in the study from a link on the website for the Hospice Volunteer Association and Hospice Educators Affirming Life Project. Results: Survey results revealed that the majority of volunteer work is in patient care, with most Hospice agencies requiring a minimum 12-month volunteer commitment and an average 4-hour volunteer shift per week. Volunteer training is separate from staff training, is provided by paid agency staff, and costs approximately $14,303 per year. Conclusions: Communication and family support are considered important curriculum topics. Revisions to current volunteer training curriculum and format are suggested.
Melissa D.a. Carlson - One of the best experts on this subject based on the ideXlab platform.
-
Hospice for nursing home residents does ownership type matter
Journal of Palliative Medicine, 2013Co-Authors: Maureen Canavan, Melissa D.a. Carlson, Heather Sipsma, Elizabeth H. BradleyAbstract:Abstract Background: Currently, more than half of all nursing home residents use Hospice at some point. Studies have shown benefits to Hospice enrollment for patients; however, the literature on ownership differences in Hospice care in general has indicated that for-profit Hospices offer a narrower scope of services and employ fewer professional staff. Although nursing home staffing patterns have been shown to be essential to quality of care, the literature has not explored differences in number of patients per staff member for Hospice care within nursing homes. Methods: We hypothesized that for-profit Hospices would have a higher number of patients per staff member for home care workers (HCWs), registered nurses (RNs), and medical social workers (MSWs), and this relationship would be moderated by the proportion of Hospice users living in nursing homes. Using data from the National Hospice Survey, a random sampling of all Medicare-certified Hospices operating between September 2008 and November 2009, we i...
-
Hospices enrollment policies may contribute to underuse of Hospice care in the united states
Health Affairs, 2012Co-Authors: Melissa D.a. Carlson, Emily Cherlin, Ruth Mccorkle, Colleen L Barry, Elizabeth H. BradleyAbstract:Hospice use in the United States is growing, but little is known about barriers that terminally ill patients may face when trying to access Hospice care. This article reports the results of the first national survey of the enrollment policies of 591 US Hospices. The survey revealed that 78 percent of Hospices had at least one enrollment policy that may restrict access to care for patients with potentially high-cost medical care needs, such as chemotherapy or total parenteral nutrition. Smaller Hospices, for-profit Hospices, and Hospices in certain regions of the country consistently reported more limited enrollment policies. We observe that Hospice providers’ own enrollment decisions may be an important contributor to previously observed underuse of Hospice by patients and families. Policy changes that should be considered include increasing the Medicare Hospice per diem rate for patients with complex needs, which could enable more Hospices to expand enrollment.
-
Geographic Access to Hospice in the United States
Journal of palliative medicine, 2010Co-Authors: Melissa D.a. Carlson, Elizabeth H. Bradley, R. Sean MorrisonAbstract:Abstract Background: Despite a 41% increase in the number of Hospices since 2000, more than 60% of Americans die without Hospice care. Given that Hospice care is predominantly home based, proximity to a Hospice is important in ensuring access to Hospice services. We estimated the proportion of the population living in communities within 30 and 60 minutes driving time of a Hospice. Methods: We conducted a cross-sectional study of geographic access to U.S. Hospices using the 2008 Medicare Provider of Services data, U.S. Census data, and ArcGIS software. We used multivariate logistic regression to identify gaps in Hospice availability by community characteristics. Results: As of 2008, 88% of the population lived in communities within 30 minutes and 98% lived in communities within 60 minutes of a Hospice. Mean time to the nearest Hospice was 15 minutes and the range was 0 to 403 minutes. Community characteristics independently associated with greater geographic access to Hospice included higher population den...
-
Benefits and challenges in use of a standardized symptom assessment instrument in Hospice.
Journal of palliative medicine, 2010Co-Authors: Dena Schulman-green, Emily Cherlin, Ruth Mccorkle, Melissa D.a. Carlson, Karen Beckman Pace, Janet E Neigh, Meliessa Hennessy, Rosemary Johnson-hurzeler, Elizabeth H. BradleyAbstract:Abstract Background: Hospices are now mandated to perform routine quality assessment under the final Medicare Hospice Conditions of Participation, creating an opportunity to explore standardized approaches to monitoring Hospice quality. Objective: We report Hospice staff experiences using a standardized symptom assessment instrument, the Edmonton Symptom Assessment System (ESAS), in a pilot study designed to develop and test quality measures on symptom management. Use of the ESAS illustrates the benefits and challenges arising with standardized symptom assessment for quality monitoring in Hospice. Methods: We interviewed 24 individuals representing 8 Hospices involved with the National Association for Home Care & Hospice Quality Assessment Collaborative, which pilot tested the ESAS as a source of standardized data for quality assessment. Transcripts were analyzed using the constant comparative method. Results: Participants reported benefits and challenges with the ESAS. Benefits were that the ESAS was a b...
-
ownership status and patterns of care in Hospice results from the national home and Hospice care survey
Medical Care, 2004Co-Authors: Melissa D.a. Carlson, William T Gallo, Elizabeth H. BradleyAbstract:Background:The number of for-profit Hospices increased nearly 4-fold over the past decade, more than 6 times the growth of nonprofit Hospices. Despite this growth, the impact of ownership on Hospice care is largely unknown. We sought to assess differences in the provision of services to patients of
Ruth Mccorkle - One of the best experts on this subject based on the ideXlab platform.
-
national Hospice survey results for profit status community engagement and service
JAMA Internal Medicine, 2014Co-Authors: Melissa D Aldridge, Ruth Mccorkle, Colleen L Barry, Mark Schlesinger, Sean R Morrison, Rosemary Hurzeler, Elizabeth H. BradleyAbstract:Importance The impact of the substantial growth in for-profit Hospices in the United States on quality and Hospice access has been intensely debated, yet little is known about how for-profit and nonprofit Hospices differ in activities beyond service delivery. Objective To determine the association between Hospice ownership and (1) provision of community benefits, (2) setting and timing of the Hospice population served, and (3) community outreach. Design, Setting, and Participants Cross-sectional survey (the National Hospice Survey), conducted from September 2008 through November 2009, of a national random sample of 591 Medicare-certified Hospices operating throughout the United States. Exposures For-profit or nonprofit Hospice ownership. Main Outcomes and Measures Provision of community benefits; setting and timing of the Hospice population served; and community outreach. Results A total of 591 Hospices completed our survey (84% response rate). For-profit Hospices were less likely than nonprofit Hospices to provide community benefits including serving as training sites (55% vs 82%; adjusted relative risk [ARR], 0.67 [95% CI, 0.59-0.76]), conducting research (18% vs 23%; ARR, 0.67 [95% CI, 0.46-0.99]), and providing charity care (80% vs 82%; ARR, 0.88 [95% CI, 0.80-0.96]). For-profit compared with nonprofit Hospices cared for a larger proportion of patients with longer expected Hospice stays including those in nursing homes (30% vs 25%; P = .009). For-profit Hospices were more likely to exceed Medicare’s aggregate annual cap (22% vs 4%; ARR, 3.66 [95% CI, 2.02-6.63]) and had a higher patient disenrollment rate (10% vs 6%; P Conclusions and Relevance Ownership-related differences are apparent among Hospices in community benefits, population served, and community outreach. Although Medicare’s aggregate annual cap may curb the incentive to focus on long-stay Hospice patients, additional regulatory measures such as public reporting of Hospice disenrollment rates should be considered as the share of for-profit Hospices in the United States continues to increase.
-
Hospices enrollment policies may contribute to underuse of Hospice care in the united states
Health Affairs, 2012Co-Authors: Melissa D.a. Carlson, Emily Cherlin, Ruth Mccorkle, Colleen L Barry, Elizabeth H. BradleyAbstract:Hospice use in the United States is growing, but little is known about barriers that terminally ill patients may face when trying to access Hospice care. This article reports the results of the first national survey of the enrollment policies of 591 US Hospices. The survey revealed that 78 percent of Hospices had at least one enrollment policy that may restrict access to care for patients with potentially high-cost medical care needs, such as chemotherapy or total parenteral nutrition. Smaller Hospices, for-profit Hospices, and Hospices in certain regions of the country consistently reported more limited enrollment policies. We observe that Hospice providers’ own enrollment decisions may be an important contributor to previously observed underuse of Hospice by patients and families. Policy changes that should be considered include increasing the Medicare Hospice per diem rate for patients with complex needs, which could enable more Hospices to expand enrollment.
-
Benefits and challenges in use of a standardized symptom assessment instrument in Hospice.
Journal of palliative medicine, 2010Co-Authors: Dena Schulman-green, Emily Cherlin, Ruth Mccorkle, Melissa D.a. Carlson, Karen Beckman Pace, Janet E Neigh, Meliessa Hennessy, Rosemary Johnson-hurzeler, Elizabeth H. BradleyAbstract:Abstract Background: Hospices are now mandated to perform routine quality assessment under the final Medicare Hospice Conditions of Participation, creating an opportunity to explore standardized approaches to monitoring Hospice quality. Objective: We report Hospice staff experiences using a standardized symptom assessment instrument, the Edmonton Symptom Assessment System (ESAS), in a pilot study designed to develop and test quality measures on symptom management. Use of the ESAS illustrates the benefits and challenges arising with standardized symptom assessment for quality monitoring in Hospice. Methods: We interviewed 24 individuals representing 8 Hospices involved with the National Association for Home Care & Hospice Quality Assessment Collaborative, which pilot tested the ESAS as a source of standardized data for quality assessment. Transcripts were analyzed using the constant comparative method. Results: Participants reported benefits and challenges with the ESAS. Benefits were that the ESAS was a b...
