title: Use of a report card to implement a network-based palliative care program.
abstract: OBJECTIVE
  To report on implementation of a Veterans Affairs (VA) network-wide, standardized, high-quality palliative care (PC) program using a Web-based PC Report Card for performance monitoring and improvement.
  
  
  METHODS
  The PC director and coordinator and facility directors established interdisciplinary teams at five acute care and three nursing home sites. Teams were trained together and subsequently met quarterly for ongoing training. Additionally, the PC director and coordinator developed and implemented a Web-based PC Report Card on the network Intranet for PC coordinator to report performance data monthly to the PC teams.
  
  
  RESULTS
  The number of patients in the network who received PC consults more than doubled in the first 4 years of the PC program. The percentage of deaths with PC consultation prior to death increased from 23% in fiscal year (FY) 2002 to 57% in FY06. Over the same period, the average days between the initial PC consultation and patients' death across all sites increased from 23 days to 106 days.
  
  
  CONCLUSIONS
  All the sites established PC teams and the number of consultations showed a sustained increase over baseline in 2002. All sites improved on the key process measures captured by the Report Card.
authors.affiliation: Program of Research on Serious Mental and Physical Illness, Geriatric Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York 10468, USA. joan.penrod@mssm.edu
authors.forename: Joan D
authors.initials: JD
authors.lastname: Penrod
authors.forename: Therese
authors.initials: T
authors.lastname: Cortez
authors.forename: Carol A
authors.initials: CA
authors.lastname: Luhrs
mesh_terms: D000208:Acute Disease / Q000451:nursing; D019985:Benchmarking; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D009735:Nursing Homes; D010166:Palliative Care / Q000458:organization & administration* / Q000592:standards; D014481:United States; D014493:United States Department of Veterans Affairs