The New York City Palliative Care Quality Improvement Collaborative.
BACKGROUND
Care for persons living with fatal chronic conditions is expensive and challenging, and can be unreliable. A quality improvement collaborative was conducted to develop capacity among health care providers in a single geographic area-New York City-to apply quality improvement methodology to palliative care services..


METHODS
The Palliative Care Quality Improvement Collaborative (PC-QuIC) modified the Institute for Healthcare Improvement's Breakthrough Series model by delivering four year-long implementation cycles, with 18-24 teams in each wave and 82 teams overall.


RESULTS
Substantial improvements were noted in most of the team projects (advance care planning, pain, family support, coordination of care), and substantial gains were made in familiarity with continuous quality improvement (CQI) techniques and in building palliative care programs and networks.


CONCLUSIONS
Collaborative rapid-cycle QI projects in a limited geographic area can be efficient in building and sustaining improved care for persons nearing the end of their lives, especially when the work involves the broad range of organizations that care for this patient population. PC-QuIC's experience illustrates the growing strength of palliative care services, but also demonstrates the challenges that confront further refinement and expansion of high-quality palliative care.
Gould
David A
DA
United Hospital Fund, New York City, NY, USA. dgould@uhfnyc.org
Lynn
Joanne
J
Halper
Deborah
D
Myers
Sarah K
SK
Simon
Lin
L
Holmes
Hollis
H
D032722:Advance Care Planning / Q000458:organization & administration; D058016:Health Facility Administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D017146:Models, Organizational; D009519:New York City; D059408:Pain Management; D010166:Palliative Care / Q000458:organization & administration*; D010347:Patient Care Planning / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration*