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The Joint Commission “speaks up” for palliative care

Buck, Harleah G. PhD, RN, CHPN

doi: 10.1097/01.NURSE.0000428707.96625.67

Harleah G. Buck, a board-certified hospice and palliative care nurse, is currently an assistant professor at the School of Nursing, Pennsylvania State University, University Park, Pa. She was formerly a nurse at The Hospice of the Florida Suncoast in Largo, Fla.

Issues in palliative and end-of-life care

The author has disclosed that she has no financial relationships related to this article.

THE JOINT COMMISSION (TJC) is an organization that has accredited most healthcare organizations and programs in the United States since 1951. Your personal experience with TJC accreditation visits may be limited to attending meetings, gathering information, and organizing medication areas, but what TJC really focuses on is continuous quality improvement in healthcare—assuring that safe, effective, high quality care is delivered across settings of care.1

TJC has initiated two new programs to assure that this continuous quality improvement process applies to palliative care. The first is the Advanced Certification Program for Palliative Care, which evaluates inpatient palliative care programs for compliance with current best practices. This program has been in existence since 2011. For details, visit

The second program, called “Speak Up: What You Need to Know about Your Serious Illness and Palliative Care,” is an educational campaign to help patients and families deal with the emotional, physical, and spiritual concerns of living with a serious or terminal illness. TJC has teamed up with several national palliative care organizations to get information about palliative care into the hands of patients and their families. Introduced in 2012, this campaign is part of a larger educational initiative that's been in place since 2002.

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Spell it out

“Speak Up” is an acronym designed to help get key information out to the public and increase the “stickiness” of the message. Each letter reinforces an important part of the message:

S: Speak up and keep speaking if you have questions or concerns about your body or your health.

P: Pay attention to the treatments, medications, and healthcare providers who are providing your care. Double check everything.

E: Educate yourself about your diagnosis, tests, and treatment plan.

A: Ask someone you trust to advocate for you.

K: Know your medications and why you're taking them.

U: Use only healthcare organizations accredited by TJC.

P: Participate in your own treatment decisions. Quality healthcare takes teamwork, and the patient should be the quarterback.

A free, downloadable Speak Up brochure is available at It begins with a simple definition of palliative care, then leads the patient through a series of palliative care topics in a simple question-and-answer format.

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What nurses can do

What role can you play in this educational campaign? First, educate yourself about palliative care. Visit these two websites:


Click on links and review various web pages to make sure you can clearly define palliative and hospice care for your patients.

Next, find opportunities in your practice setting to use these resources to educate patients and families. Download and print copies of the Speak Up brochure and have them available for people facing a serious illness. In addition, apply the Speak Up principles to your everyday practice. Empower patients to ask questions (and keep asking them), take nothing for granted, educate themselves, enlist advocates, know their medications and other treatments, and use only accredited healthcare facilities. In short, encourage them to own their healthcare.

Finally, if your practice setting doesn't have an Advanced Certification Program for Palliative Care, advocate for one as a means to improve patient care, provide a program framework and assessment process, and promote a cohesive team with a culture of excellence. Be part of the continuous quality improvement process in your own practice.

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1. The Joint Commission. Facts about The Joint Commission.
© 2013 Lippincott Williams & Wilkins, Inc.