New Jersey ranks 47th in the nation in hospital death for seniors at the end of their lives, a statistic that translates “into real people treated with unnecessary and unwanted medical care at the end of their lives,” when they’d prefer to die at home, a New Jersey health advocacy group says.
In an effort to improve end-of-life care in the state, the New Jersey Health Care Quality Institute has released a blueprint outlining changes that policymakers and providers should adopt.
"A statewide strategic plan for end-of-life care should be established and implemented by both the public and private sector in close cooperation," authors from the institute wrote.
Four changes recommended by the institute:
1. Financially support technology solutions. The blueprint calls for a statewide electronic Practitioner Orders for Life-Sustaining Treatment registry so clinicians and patients can document end-of-life care wishes accessible no matter where the patient may be. This registry should be compatible with electronic health records to identify patients in need of an end-of-life care plan.
2. Change payment policy. Medicaid and the state health benefits program should increase reimbursements for end-of-life consultations outside the hospital and increase reimbursements for palliative care. Alternative payment models that reward end-of-life quality measure should also be implemented.
3. Engage and educate providers. Medical and nursing students should have better resources to learn what end-of-life care discussions should look like, and the state should develop a core curriculum around this topic. Providers should also offer web-based and in-person trainings for clinicians.
4. Change the culture. Awareness campaigns for patients about end-of-life care options that involve community leaders should be offered in multiple languages to help engage and inform the patient population of their options.