Promoting Excellence : Report Summary : Future Directions

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The current hopeful findings and positive programmatic experience carry important implications for health policy. When the focus is on patients with progressive disease and high burdens of illness, access to palliative care services, quality of care and control of costs appear well aligned. Preliminary results suggest that the savings, particularly in unplanned hospitalizations, exceed the invested costs of care coordination, symptom control, crisis management and other elements of palliative care.

Well-designed, large-scale studies are required to test these early indications of preserved quality of life, improved system operations, decreased service utilization, prevention of caregivers’ burden and secondary health costs, and, most intriguingly, positive impact on survival.

The creative, collaborative work of the clinicians, researchers and administrators involved in Promoting Excellence in End-of-Life Care projects across the country represent a foundation of experience and empiric evidence. Further research and policy development will enable us to remove the artificial distinctions between living with serious illness and dying and dissolve unnecessary impediments to improving comfort, ensuring family support and enhancing the quality of life’s end for all Americans.

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Promoting Excellence in End of-Life Care is a National Program Office of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying persons and their families. Visit for more resources.

Promoting Excellence