title: Palliative Care Scorecard.
abstract: In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public.
  
  
  
  Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard.
  
  
  
  The scorecard was organized into a format of quality measures identified by the Measuring What Matters (MWM) project that are defined as important to the team, automatically extracted from the electronic health record, valid, and can be impacted over time.
  
  
  
  The scorecard was initially created using University of Florida Health (UF) data, a new PC program, and successfully applied and implemented at University of Colorado Anschutz Medical Campus (CU), a second institution with a mature PC program.
  
  
  
  Clinical metrics are organized in the scorecard based on MWM and described in terms of the metric definition, rationale for selection, measure type (structure, process, or outcome), and whether this represents a direct or proxy measure.
  
  
  
  The process of constructing the scorecard helped identify areas within both systems for potential improvement in team structure, clinical processes, and outcomes. In addition, by automating data extraction, the scorecard decreases costs associated with manual data entry and extraction, freeing clinical staff to care for patients and increasing the value of PC delivered to patients.
authors.affiliation: 1 Division of Hospital Medicine, Department of Medicine, University of Florida , Gainesville, Florida.
authors.forename: Sheri
authors.initials: S
authors.lastname: Kittelson
authors.affiliation: 2 Department of Medicine, Institute for Healthcare Quality, Safety, and Efficiency, Hospital Medicine Group, University of Colorado School of Medicine , Aurora, Colorado.
authors.forename: Read
authors.initials: R
authors.lastname: Pierce
authors.affiliation: 3 Department of Medicine, University of Colorado Hospital Palliative Care Service, University of Colorado School of Medicine , Aurora, Colorado.
authors.forename: Jeanie
authors.initials: J
authors.lastname: Youngwerth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D017051:Hospice Care / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D010166:Palliative Care / Q000191:economics* / Q000706:statistics & numerical data*; D015397:Program Evaluation; D014481:United States
keywords: Medicare hospice benefit; advance directives; hospital-specific palliative care issues; policy and finance; symptom assessment