JAMA identifies 3 key areas where palliative care can be improved to better serve patients: systems of care, measurements and accountability and national policy change. JAMA emphasizes teaching clinicians to change their goals and put the patients goals first. They also stress the importance of measuring these goals, and suggests documenting conversations with patients and their families regarding what matters most to them will help increase accountability. On a national level, JAMA discusses the mismatch between the funding and the community's goals.
To improve palliative care for patients with serious illness, 3 changes must occur. First, palliative care specialists need to develop skills in clinician behavior change, system change, and quality improvement. Second, health systems need to expand their focus to develop programs that measure and improve the quality of palliative care that every patient receives. Third, federal funding must be aligned with a national goal of improving the experience of seriously ill patients and their loved ones.