Clinical Standards and Guidelines
The National Consensus guidelines are a landmark publication that “create a blueprint" for excellence by establishing a comprehensive foundation for gold-standard palliative care for all people living with serious illness, regardless of their diagnosis, prognosis, age or setting.
The Coalition to Transform Advanced Care (CTAC) describes the principles they believe should guide care for people with serious illness, especially those most in need.
The site offers “Your Symptoms Matter”, assessment tools, information, clinical guideline, algorithms and patient guides for a comprehensive set of symptoms that cut across different diagnoses. There is also a link to a smart device app.
Information and downloadable materials on a scale used to measure family satisfaction, designed for care of patients with advanced cancer. Validity evidence for the tool has been gathered in a number of different settings, including inpatient units, outpatient cancer clinics and home care. It is used in North America, Australia and Europe.
An annotated set of links take you to tools related to pain and symptom management, functional status, psychosocial care, caregiver assessments and quality of life. Although the site is focused on research purposes most of the tools have potential clinical value.
This Australian site has developed a booklet full of palliative care assessment tool with international relevance.
These guidelines for palliative care focus on cancer patients but most content will generalize to all patients with serious illness.
The palliative care and hospice framework endorsed in this report is intended as the first step in creating a comprehensive quality measurement and reporting system for palliative care and hospice services. The framework also served as a road map for the identification of a set of NQF-endorsedTM preferred practices aimed at improving palliative and hospice care across the Institute of Medicine’s six dimensions of quality—safe, effective, timely, patient centered, efficient, and equitable.
The Coalition for Compassionate Care of California offers decision aids combining evidence with patient and family accessible language on topics such as ventilators, tube feedings, artificial hydration and CPR, translations in Spanish and Chinese available.
Washington Rural Palliative Care Initiative developed a guide to assist with implementation of Advanced Care Planning.
Screening and Assessment Tools
There is not a simple answer to the question, “who should be served by a palliative care service?” Some organizations rely on diagnosis alone, while others use screening tools or clinical discernment. The list of links below includes tools used for clinical assessment and screening for patient selection for services. The list below offers does not presume to be comprehensive and gives samples.
The Washington Rural Palliative Care Initiative continues to test and refine this screening tool, adapted from one in use in Minnesota. A short training video on how to use the tool was made available in Spring 2019. The scoring threshold for service eligibly is determined by the organization and may be dynamic as capacity changes.
Other Assessment Tools
- ESAS-r Guidelines
- ESAS-r Graph
- NCCN Distress Thermometer
- ECOG Performance Status
- Primary Triggers for Palliative Care
- POS Questionnaire v1 PatientEN
- POS Questionnaire v2 PatientEN
- Needs End of Life Screening NEST
- Palliative Performance Status Scale
- Palliative Performance Scale v2
- ED Screening Tool Older Adults
- Predictive Modeling Risk Stratification