RWJF funds 21 innovative end-of-life projects
News From the End of Life
RWJF funds 21 innovative end-of-life projects
The Princeton, NJ-based Robert Wood Johnson Foundation announced in late October the award of 21 grants under its Promoting Excellence in End-of-life Care program. The projects, chosen from a pool of 678 applicants, include two hospices as primary grantees and several other hospices participating in collaborative efforts. Most of the three-year grants average $450,000, with a total of $9.1 million awarded.
"These projects have fresh ideas on how to make the fundamental changes we need in the structure, organization, and priorities of the health care system in order to promote high-quality end-of-life care," says program director Ira Byock, MD. "Their work, we hope, will help make changes that are long-lasting and spread to other institutions. In the long run, we hope they improve the quality of life for a great many dying patients and their families," he says.
"The array of grants responds to acknowledged barriers to excellence in end-of-life care within existing health systems and structures. The grants will fund innovative strategies in a variety of settings, with particular attention to special contexts of care such as inner cities, isolated rural areas, and even prisons."
The funded projects also target hard-to-serve populations of dying patients, including children, people with serious, long-standing mental illnesses, and renal dialysis patients.
"Many of the grants involve leading hospice programs in innovative approaches that integrate palliative care within mainstream health systems," Byock adds.
Do they thus suggest the future direction of hospice? "Promoting Excellence in End-of-Life Care was well-named," he responds. "We’re not retreating from standards of care, but we’re trying to be flexible in the methods for achieving these standards. The grantees will raise the bar for planners and policy makers in their efforts to improve quality and access to comprehensive palliative care."
End-of-life partnership inches forward
A proposed national end-of-life advocacy group called Partnership for Caring is still under development (See Hospice Management Advisor, October 1998, p. 123.) "We’ve come a distance. We’re being thoughtful in our process. And I believe we need a clearer definition before too much (publicity) splashing goes on," ob-serves J. Donald Schumacher, PsyD, CEO of the Center for Hospice and Palliative Care, Cheek-towaga, NY, and one of the Partnership’s planners. Other leaders are Ira Byock, MD, past president of the Reston, VA-based American Association of Hospice and Palliative Medicine, and Karen Kaplan, executive director of Wash-ington, DC-based Choice in Dying.
The group’s aims include channeling public concerns about end-of-life care into public advocacy, public education, and major advocacy campaigns in various media about the right to quality care at the end of life. "Just as the National Hospice Organization is talking about public engagement, we’d like to identify a process for beginning to engage people in a national conversation" about end-of-life care, Schumacher says. However, it will be important to include perspectives and voices from beyond the provider community in order to achieve those goals. Next step is a strategic planning session planned for Dec. 1, probably in the Washington, DC, area, he adds, bringing together 15 to 20 industry leaders to work on the organization’s goals and vision.
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