"But until the Joint Commission's advanced certification program, there were no quality metrics or quality standards that were uniform across the board that would allow patients and their families to say, 'Aha, this hospital has a high quality palliative care team.' "
Even though many hospitals say they have palliative care programs, what they have often falls far short because resources and expertise are either not available or not available all the time, he says.
3 Challenges to Palliative Care Programs
Palliative care programs that meet tough standards have been hard to develop for three reasons, Morrison says.
First: "There's still a misperception by hospitals (leaders) that palliative care is about end of life care, and that like the public, they need to understand and we need to better educate that there's a better way to take care of people with serious illness."
Second: "It's not a revenue-generating program." Under fee for service payment models, if there is not an operation or procedure, "it doesn't fit well within the hospital's model." That will probably change as accountable care organizations and other payment models emerge under the Affordable Care Act.
Third: There aren't enough people trained in palliative care or board certified in geriatric medicine. "It's a new specialty and there are simply not enough trained (palliative) physicians and nurses right now to fill the need. We really need some specific federal policies to promote the workforce issue."