This VNAA Blueprint for Excellence: Pathways to Best Practices At The End Of Life was created to support hospices in adopting evidence-based, expert recommended care. VNAA’s End of Life Best Practice Work Group guided development of this material and identified best practice recommendations.

VNAA member organizations are committed to delivering high quality, compassionate community-based hospice care.  This website helps members adopt best practices consistent with recommendations developed by the Institute of Medicine (IOM, 2013) and the National Consensus Project’s Clinical Practice Guidelines for Quality Palliative Care (NCP, 2009) and other research. Information presented here tracks with the Centers for Medicare and Medicaid Services (CMS) Conditions  of Participation (73 FR 32204, 2008) and helps hospices to fully implement the hospice quality of care requirements (CMS, 2010) identified in the Hospice Item Set.

This site focuses on hospice professionals caring for patients in their final days or hours. MEDPAC reports that 2011, 10 percent of all Medicare patients entering hospice had a length of stay of 2-3 days and 25 percent of patients had a length of stay of seven days or less regardless of diagnosis (MEDPAC, 2013). That means hospice professionals regularly admit patients in their final days or hours; they need to rapidly and fully implement focused assessments and interventions to ensure patients’ physical and emotional comfort.

The site links to multi-disciplinary validated, reliable tools to support hospice practice and measure the quality of hospice care.  It also links to guidelines, resources and educational opportunities to support high quality end of life care.  This brief information guides hospices to resources enabling them tailor programs to ensure patient-centered care for diverse populations - including people who can self-report their needs and those who cannot. 

This module links to detailed hospice best practice recommendations on the following topics:

• End of Life Crisis Management
• Critical Initial Hospice Interventions
• Pain Assessment and Management
• Dyspnea Assessment and Management
• Managing Other Distressing Symptoms
• Hospice Patient Safety: managing medications and preventing falls

• Engaging Patients: treatment preferences and spirituality