In its first update since 2009 to the “Clinical Practice Guidelines for Quality Pallative Care”, the National Consensus Project for Quality Pallative Care states that palliative care should follow the care coordination and quality improvement processes that are called for by the Affordable Care Act. The guidelines state that the ACA’s delivery and payment models provided a way for hospice and palliative care providers to join accountable care organizations and bundled payment groups and thus the best practices should be followed in order to promote palliative care across all settings.

The guidelines also state that providers should start using quality assessment and performance improvement (QAPI) reviews as a part of a way to improve outcomes through ongoing data driven processes. “Quality improvement activities are routine, regular, reported, and demonstrate influence upon clinical practice. Designated staff with experience in QAPI planning, direct the QAPI process in collaboration with leaders of the palliative care program.”

The guidelines were also revised on the psychological and psychiatric aspects of care such as adding a section on bereavement programs. This section calls for an assessment at admission to identify families who may have complicated bereavements and specifically with older adults who may be at risk for developing co-morbid complications related to grief.