全球智库信息集成服务系统

This paper, from The Commonwealth Funds international program, examines the origins, content, and potential impact of England's evidence-based End-of-Life Care Strategy. Challenges addressed include moving such care beyond the province of hospice and palliative-care specialists and initiating palliative services before the patient's final days. Aspects of the English approach that may be useful in the U.S include helping physicians recognize when patients are entering a trajectory that may end in death, the use of "death at home" as a metric for measuring progress, improving the skills of clinical and caregiving personnel through Web-based training, and developing a national improvement pathway.