Context

Several national reports, produced by the Institute of Medicine, the National Cancer Policy Board and others, have set strategic road maps for the nation to advance palliative care research and clinical practice. There is now a national consensus document defining the quality of palliative care. The National Institutes of Health (NIH) recently reviewed the state of the science of end-of-life care and articulated a research agenda. Hospital-based palliative care teams are emerging and hospice programs themselves are seeking to expand access to patients with non-cancer diagnoses and to previously underserved populations, especially minority communities. In fact, it is now clear that hospice is providing care for an ever increasing proportion of the 2.4 million Americans who die annually, and that non-cancer patients are the fastest growing population in hospice care. Furthermore, the aging of the population will continue to place even greater emphasis on the need for palliative and end-of-life services. Healthcare providers are being encouraged to seek certification in palliative medicine and hospice care. All of these efforts have the effect of expanding the expectations of consumers and professionals to:

• Increase access to care for populations that are currently under-served (ethnic minorities, frail elderly, patients with life-limiting illness but for whom a six-month prognosis for survival may not be determined with certainty),
• Enact measures that promote consistent, non-fragmented, high quality palliative and end-of-life care,
• Provide adequate funding to support patient and provider needs. Unfortunately, federal research funding has increased only modestly, and private foundation funding has significantly declined within the past several years.

Given these realities, the Institute occupies a strategic position to exert regional, national and global influence on the future of end-of-life care. This is so because the Institute:

• Has a stable financial base to support permanent faculty and staff,
• Is located within a highly regarded research-intensive university in which established scholars and clinicians already work in the field of palliative medicine and end-of-life care,
• Will be moving to approximately 5,000 sq. ft. of new space in the divinity school’s addition, with state-of-the-art conference and teaching facilities and room to support growth of faculty and programs.

As a first step toward fulfilling the promise and potential of the Institute, the new leadership has created a strategic vision, including a revised mission statement and guiding principles as well as a new conceptual model, within which the ICEOL will operate to move its agenda forward.