Health care professionals seeking to improve the quality of life for those living with serious illness and nearing the end of life will find exactly what their organization needs in the second edition of this acclaimed book by Dr. Joanne Lynn and her colleagues. Improving Care for the End of Life provides expert guidance on how to make significant improvements now, at all levels of the health care system from the bedside and the hospital to the health care policy and legislative arenas by using the rapid-cycle breakthrough approach to change. The ideas are proven, and the stories of teams that have put them to use will inspire and enlighten. New to the second edition: BL New chapters to address issues of growing interest such as continuity of care, and the special needs of dementia patients and their loved ones. BL Details on trajectories of care and how these affect decisions at the end of life BL Updated and expanded information on pain management, advance care planning, ventilator withdrawal, depression and delirium, advanced heart and lung disease, and more BL Scores of new insights, measurement approaches, and tips based on the experiences of hundreds of improvement teams nationwide BL Thoroughly updated references The sourcebook speaks to all managers of health care systems serving people with serious illnesses, including doctors in offices, nurse managers on hospital units, social workers in long-term care facilities, administrators of home care and hospice agencies, hospital chaplains, directors of volunteer services, and others.

Part One: Overview. 1. Introduction: Continuous Quality Improvement for Better End-of-Life Care 2. How to Make Improvement Happen Part Two: Improved Patient Care Through Improved Practice and Systems. 3. Preventing, Assessing and Treating Pain 4. Managing Dyspnea and Ventilator Withdrawal 5. Beyond the Living Will: Advance Care Planning for All Stages of Health and Disease 6. Relationships, Spirituality and Bereavement: Support for Difficult Times 7. Preventing and Healing Pressure Ulcers 8. Continuity of Care: Ways to Improve Patient Confidence in the Health Care System Part Three: Arrangements to Promote Reform. 9. Hospital-Based "Palliative Care" Consults and Units 10. Beyond Number Crunching: Ways to Use Information Systems in Quality Improvement 11. Caring for Caregivers: Helping Staff to Provide Good Care 12. Law, Policy, and Finance Part Four: Opportunities in Specific Diseases. 13. Alzheimer's and Other Dementias: Opportunities to Honor Life 14. Opportunites to Improve Care for Cancer Patients 15. Depression and Delirium 16. Offering End-of-Life Services to Patients with Advanced Heart or Lung Failure 17. Conclusion:Getting Started Appendix: Instruments. Resources. Glossary. References. Index.

Joanne Lynn, M.D.Director, RAND Center to Improve Care of the Dying, Janice Lynch Schuster, Anne Wilkinson, Lin Noyes Simon

"This book aims to equip readers with the best available advice on how to make substantial improvements in the health care system so that it serves the seriously ill person who is coming to the end of life. And that's just what it does. This book is the result of a year-long collaborative project, co-sponsored by the Center to Improve Care of the Dying and the Institute for Healthcare Improvement, that included more than four dozen health care organisations committed to changing practices for the sake of real quality improvement in end-of-life care. This is an excellent resource and should be required reading for anyone in palliative care who is interested in improving any aspect of the care they give to patients and families. It is well written and immensely practical. Reading it leaves you feeling motivated to get out there and do something--this week! Highly recommended."----Roger Woodruff, Director of Palliative Care, Austin & Repatriation Medical Centre, Melbourne, Australia |k No