Developing a Database and Quality Metric Dashboard to Encourage Quality Improvement for Patients at the End of Life Through Community-Based Hospice Partnerships (GP739)

• Identify initial steps to build partnerships with community-based hospices with goal of improving quality of care• Understand how a database can help support a health system build partnerships with community-based hospices. UCLA Health does not provide hospice care directly but recognizes the importance of establishing relationships with community-based hospice agencies. Develop partnerships with community-based hospices to support quality improvement for patients at the end of life. We approached UCLA Health’s most commonly used community-based hospice agencies between January 2016 and April 2019 with the goal of developing partnerships to monitor and improve the quality of care for patients at the end of life. As part of the partnership, we asked hospice agencies to provide monthly reports to UCLA Health about patient referrals, enrollment, diagnoses, length of stay (LOS), and death/discharge status using a structured excel template. Data from the excel template were imported into a Microsoft Access database so that quality metrics could be displayed on a dashboard to showcase hospice performance and quality. Analysis was based on data collected between July 2018 and June 2019. We developed partnerships with 12 community-based hospice agencies. Although most hospice admissions came from the outpatient setting, these 12 hospices covered nearly 80% of hospital discharges from the health system. 8/12 hospices reported patient data for all months and 4/12 hospices reported monthly data for at least half of the months. Of 1,003 patients referred to hospice, 516 (51%) enrolled in community-based hospice, of which 367 (71%) died in hospice by June 2019 (median: 20 patients per hospice, range: 1-156 patients per hospice). The LOS of patients who died in hospice ranged from 4-57 days depending on the hospice agency, with an average LOS of 18 days. It is important for hospice agencies to report their patient data. Hospice data can reveal differences in end-of-life outcomes for UCLA Health patients.