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Center for Health Services and Outcomes Research

End of Life Care

Measuring What Matters in Hospice and Palliative Care

Measuring the quality of hospice and palliative care is critical for evaluating and improving care, but no standard U.S. quality indicator set exists.  The Measuring What Matters project aimed to recommend a concise portfolio of valid, clinically relevant, cross-cutting indicators for internal measurement of hospice and palliative care.

In a sequential consensus process with the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, candidate indicators were mapped to National Consensus Project Palliative Care Guidelines domains. The list was then narrowed through a modified Delphi rating process. The final list consisted of 10 indicators covering domains of structure and process, physical aspects, psychological and psychiatric aspects, spiritual and existential aspects, and ethical and legal aspects. The consensus set of indicators is a foundation for standard valid internal quality measurement for U.S. settings.


Dy SM, Kiley KB, Ast K, Lupu D, et al.  (2015)  Measuring What Matters: Top-ranked quality indicators for hospice and palliative care from the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association.  Journal of Pain and Symptom Management, 49: 773-781.

Dy SM, Herr K, Bernacki RE, Kamal AH, Walling AM, Ersek M, Norton SA. (2016) Methodological Research Priorities in Palliative Care and Hospice Quality Measurement. Journal of Pain and Symptom Management, 51(2):155-62.