Dissemination of a successful dementia care program: Lessons to facilitate spread of innovations.

Background: Despite the effectiveness of innovations to improve the care of persons with dementia, there has been limited diffusion of these into widespread clinical practice. We aimed to identify common barriers and address them directly in the initial phase of dissemination of a successful dementia care program.

Methods: Description of and early experience with a dissemination strategy of the UCLA Alzheimer's and Dementia Care Program to health care systems nationwide.

Recommendations to Improve Payment Policies for Comprehensive Dementia Care.

Access to comprehensive dementia care is limited. Recent changes in billing for professional services, including new physician fee schedule codes, encourage clinicians to provide new services; however, current reimbursement does not cover costs for all needed elements of dementia care. The Payment Model for Comprehensive Dementia Care Conference convened more than 50 national experts from diverse perspectives to review promising strategies for payment reform including ways to accelerate their adoption.

Designing Effective Payer Models to Improve Serious Illness Care.

Improving care for patients with serious illness requires building reliable supports across settings and over time. Consistency of approach by payers can simplify and accelerate provider-based solutions. Early attention to predictable challenges and shared principles can help guide design to more sustainable solutions.

Palliative Care Leadership Centers Are Key To The Diffusion Of Palliative Care Innovation.

Between 2000 and 2015 the proportion of US hospitals with more than fifty beds that had palliative care programs tripled, from 25 percent to 75 percent. The rapid adoption of this high-value program, which is voluntary and runs counter to the dominant culture in US hospitals, was catalyzed by tens of millions of dollars in philanthropic support for innovation, dissemination, and professionalization in the palliative care field. We describe the dissemination strategies of the Center to Advance Palliative Care in the context of the principles of social entrepreneurship, and we provide an in-depth look at its hallmark training initiative, Palliative Care Leadership Centers.

Impact of Staffing on Access to Palliative Care in U.S. Hospitals.

Background: Over the past decade over two-thirds of U.S. hospitals have established palliative care programs.

The diverse landscape of palliative care clinics.

Background: Many health care organizations are interested in instituting a palliative care clinic. However, there are insufficient published data regarding existing practices to inform the development of new programs.

Objective: Our objective was to obtain in-depth information about palliative care clinics.

Rapid reengineering of acute medical care for Medicare beneficiaries: the Medicare innovations collaborative.

In 2009 we described a geriatric service line or "portfolio" model of acute care-based models to improve care and reduce costs for high-cost Medicare beneficiaries with multiple chronic conditions. In this article we report the early results of the Medicare Innovations Collaborative, a collaborative program of technical assistance and peer-to-peer exchange to promote the simultaneous adoption of multiple complex care models by hospitals and health systems. We found that organizations did in fact adopt and implement multiple complex care models simultaneously; that these care models were appropriately integrated and adapted so as to enhance their adoptability within the hospital or health care system; and that these processes occurred rapidly, in less than one year.

Hospital mortality rates: how is palliative care taken into account?

Context: Using mortality rates to measure hospital quality presumes that hospital deaths are medical failures. To be a fair measure of hospital quality, hospital mortality measures must take patient-level factors, such as goals of care, into account.

Objectives: To answer questions about how hospital mortality rates are computed and how the involvement of hospice or palliative care (PC) are recognized and handled.

The ironic business case for chronic care in the acute care setting.

The U.S. health care system provides acute care tools to deal with the problems of chronic disease, and strategies are needed to engage hospitals in chronic care innovations.

Center to Advance Palliative Care palliative care consultation service metrics: consensus recommendations.

The need to standardize the prospective collection and analysis of data has been a cornerstone of education and technical assistance provided by the Center to Advance Palliative Care (CAPC). Data analysis is vital for strategic planning, quality improvement, and demonstration of program impact to hospital administrators, private funders, and policymakers. To develop a set of core measures, CAPC convened a consensus panel in 2008 to focus on the topic of operational metrics for consultation services.