Report

Recommendations

Achieving the Promise: Transforming Mental Health Care in America (New Freedom Commission on Mental Health, 2003)

Recommendation 5.3 Improve and expand the workforce providing evidence-based mental health services and supports.

Palliative Care

Improving Palliative Care for Cancer (IOM and NRC, 2001)

Recommendation 1 The NCI should designate certain cancer centers, as well as some community cancer centers, as centers of excellence in symptom control and palliative care for both adults and children. The centers will deliver the best available care, as well as carrying out research, training, and treatment aimed at developing portable model programs that can be adopted by other cancer centers and hospitals. Activities should include but not be limited to the following:

  • formal testing and evaluation of new and existing practice guidelines for palliative and end-of-life care;

  • pilot testing “quality indicators” for assessing end-of-life care at the level of the patient and the institution;

  • incorporating the best palliative care into NCI-sponsored clinical trials;

  • innovating in the delivery of palliative and end-of-life care, including collaboration with local hospice organizations;

  • disseminating information about how to improve end-of-life care to other cancer centers and hospitals through a variety of media;

  • uncovering the determinants of disparities in access to care by minority populations that should be served by the center, and developing specific programs and initiatives to increase access; these might include educational activities for health care providers and the community, setting up outreach programs, etc.; …

  • providing in-service training for local hospice staff in new palliative care techniques.

Recommendation 5 Organizations that provide information about cancer treatment (NCI, the American Cancer Society, and other patient-oriented organizations [e.g., disease-specific groups], health insurers, and pharmaceutical companies) should revise their inventories of patient-oriented material, as appropriate, to provide comprehensive, accurate information about palliative care throughout the course of disease. Patients would also be helped by having reliable information on survival by type and stage of cancer easily accessible. Attention should be paid to cultural relevance and special populations (e.g., children).



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