Martha Twaddle, MD: Updated National Clinical Guidelines for Palliative Care

Originally created in 2001 and published in 2004, the Clinical Practice Guidelines for Quality Palliative Careemphasize critical aspects of the field. In the updated 4th edition, the authors call for critical assessment by the different members of a patient’s interdisciplinary team and emphasize the importance of the family, which includes not only biological family but also the patient’s community and support group.

“Palliative medicine is, by definition, interdisciplinary care,” said Martha L. Twaddle, MD, clinical associate professor at Northwestern University Feinberg School of Medicine, in a recent interview with MD Magazine®. “It’s about working as a team, and the interdisciplinary model is one where everyone of us has the ability to screen for distress for unmet needs outside of our area of expertise. We’re asking health care to get back to what it was originally intended to be—to take care of people in the context of their family and community and personalizing their care.”

In the interview, Twaddle added that a lack of organization largely influenced the standardization of palliative guidelines that are available today, which now form the foundation of all the accrediting that occurs in palliative care. For instance, the Joint Commission uses the guidelines to survey programs to make sure they are doing palliative care.

“The guidelines form the bedrock on which we build our quality metrics and standards,” Twaddle said. “In order to measure good care, it has to link and be related to what the guidelines say are important.”

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