What are Policies and Procedures?
Policies and procedures:
- provide ground rules for effective interaction among diverse staff
members
- reflect high-risk areas of care
- coordinate responsibilities for care processes and for preventing and
solving problems
- provide standards for assessing performance by identifying the roles and
responsibilities of various individuals
- help identify potential obstacles to efficient and consistent
performance
information among individuals and disciplines (Levenson, 1995)
Policies are usually based upon accepted, well-defined norms/standards
of practice and clinical guidelines. We have compiled a list of some
published norms/standards, guidelines, recommendations, position or
consensus papers, and principles of professional practice for
palliative care. Norms/standards of care are needed to establish
consistency, expectations and patterns for practice. They allow for
comparisons to be made and excellence to be judged. Norms/standards
articulate what is done, who is served, and what clinical services and
resources are needed. In addition, standards provide a work for
quality measurement and improvement . Policies and
procedures may also be based on professional recommendation or
consensus when standards or guidelines are not available.
Procedures delineate the processes and activities necessary to
implement policies; in other words, the day-to-day operations.
Procedures are usually based on professional guidelines when they are
available. They describe appropriate management of specific symptoms
and provide a basis for assessment, treatment and possible outcomes
. Procedures can cover processes such as symptom
assessment, care planning, medication administration and monitoring.
Policies and procedures should also accurately reflect recommendations;
laws and regulations that impact the palliative care program and host
organization. For instance, palliative care programs seeking to offer
a hospice care component under the Medicare Hospice Benefit should
incorporate HCFA regulations into policies and procedures. Standards
and recommendations made by the JCAHO may also be incorporated into
institution policies and procedures.
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CAPCManual Attribution:
von Gunten CF,
Ferris FD,
Portenoy RK,
Glajchen M, eds.
CAPCManual: How to Establish A Palliative Care Program.
New York, NY: Center to Advance Palliative Care, 2001.
©
Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, CA
and
The Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY, 2001
Permission to reproduce for non-commercial educational purposes with display of
attribution and
copyright is granted.
Last updated: February 20, 2002
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Elements
Select section:
Basis, Context, Components,
Case Examples
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Basis of Palliative Care Practice
Palliative Care Definitions
Historical Definitions
WHO
Oxford Textbook
ABHPM
NHPCO
Palliative Care
Applicability
Application to Patients at Risk
Differences–Hospice & Palliative Care
Values, Ethical Principles
Values
Ethical Principles
Conceptual Framework
Square of Care
Square of Organization
Square of Care & Organization
Norms / Standards of Practice
Guidelines
Policies, Procedures
What are they?
Developing, Implementing, Evaluating
Measures
Definitions of Common Terms
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Context
Tensions
In Therapeutic Relationships
Within Host Organizations
Within Healthcare System, Community
Who's the Customer
US Healthcare
Acute Care Hospitals
Long-term Care Facilities
Home
Hospice Care
Financing US Healthcare
Expenditures for EOL Care
Overview by Settings, Revenue Sources
Medicare
Medicaid
Commercial Insurers
Managed Care
Government (VA, Military)
Financing
Community Hospitals
Academic Hospitals
Subacute, Skilled Care
Custodial Care
Ambulatory Care
Home Care
Hospice Care
Eligibility
Covered Services
Reimbursement Rates
Unintended Consequences
Financing Physicians
Coding
Procedure / Service Codes
Coding Based on Time
Frequently Used E/M Codes
Example
Addition of Procedure Codes
Diagnosis Codes
ICD-9 Codes for Palliative Care
Avoiding Concurrent Billing Problems
Example
Documentation
Example
Physician Reimbursement
Medicare
Medicare Hospice Benefit
Non-hospice Physicians
Associated with a Hospice
Medicaid
Commercial Insurers
Managed Care
Government (VA, Military)
Financing Non-physician Providers
Hospital–Hospice Relationships
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Program Components
1º, 2º, 3º Model of Palliative Care Delivery
Interdisciplinary Care
Members of Interdisciplinary Team
Core Competencies
Physician
Nurse
Social Worker
Chaplain
Volunteer
Specialized Environments
Types of Services
Consultation Services
Consultation Etiquette
Consultation Documentation
Sample Note
Inpatient Units
Developing an Inpatient Unit
Staffing
Acuity
Nursing Model
Unit Size
General Ward vs. Palliative Care Unit
Roles
Decisions
Case Example
Nursing Staff
Physician Staff
Other Staff
Advice
Home Care
Eligibility, Medicare Home Health Benefit
Covered Services
Usually Not Covered
Hospice Care at Home
Ambulatory Outpatient Care
Respite Care
Financing Palliative Care Programs
Acute Hospital
Skilled Care Nursing Home
Hospice
Home Health
Ambulatory Outpatient
Managed Care
Financing Physicians in Palliative Care
Financing Non-physicians in Palliative Care
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Case Examples
CAPCManual Case Examples
Pioneer Program Case Examples
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