A palliative care needs assessment of health care institutions in Wisconsin.
BACKGROUND
In 1999 the Wisconsin Coalition to Improve Palliative Care (WCIPC) conducted a palliative care needs assessment of health care institutions throughout the state of Wisconsin to document the current status of palliative care and identify institutional barriers and opportunities for improvement.


METHODS
A survey instrument was developed to assess provisions of palliative care in the following areas: services currently provided, staff education programs offered in the previous year, barriers to the delivery of palliative care, and resources that would be useful to the participating institutions. Surveys were mailed to 881 health care institutions in Wisconsin; 318 (36%) surveys were returned.


RESULTS
The three most common end-of-life care services present included a program to promote advance care planning, a contractual relationship with one or more hospice programs, and an interdisciplinary care program for dying patients. Pain management and advance directives were the two most common topics of educational programs offered in the past year. The most frequently cited barriers to good end-of-life care included a lack of knowledge among patients/families, a lack of provider knowledge about pain and symptom control, and poor reimbursement for end-of-life care. Resources that institutions felt would be useful included newsletters, a speaker's bureau, and information about establishing quality improvement programs for palliative care.


CONCLUSIONS
While health care institutions in Wisconsin provide a variety of palliative care services and offer educational programs that address areas of palliative care, institutional barriers do exist. This needs assessment provides valuable descriptive data that will guide efforts to improve palliative care throughout the state of Wisconsin.
D006268:Health Facilities / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data; D017051:Hospice Care; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D020380:Needs Assessment; D010166:Palliative Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014922:Wisconsin