writing measurable outcomes for hpm competencies ability to develop a differential diagnosis for...
TRANSCRIPT
Mea
sura
ble
Out
com
es fo
r H
ospi
ce a
nd P
allia
tive
Med
icin
e (H
PM) C
ompe
tenc
ies
Vers
ion
2.3
Sept
embe
r, 20
09
Tabl
e of
Con
tent
s
Pre
face
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
.... 2
HP
M C
ompe
tenc
ies
Pro
ject
Pha
se 2
Wor
k G
roup
.....
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
..... 4
List
of P
oten
tial A
sses
smen
t Met
hods
Use
d ...
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
.... 5
Pat
ient
and
Fam
ily C
are .
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
. 6M
edic
al K
now
ledg
e ...
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
.... 1
3P
ract
ice-
Bas
ed L
earn
ing
and
Impr
ovem
ent .
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
..... 3
5In
terp
erso
nal a
nd C
omm
unic
atio
n S
kills
.....
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
39P
rofe
ssio
nalis
m ...
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
.... 5
3S
yste
ms-
Bas
ed P
ract
ice
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
......
..... 5
6
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 2
Pref
ace
Whe
n de
velo
ping
out
com
e m
easu
res
to a
sses
s co
mpe
tenc
ies
for a
Hos
pice
and
Pal
liativ
e M
edic
ine
(HP
M) s
ub-s
peci
alis
t, w
e m
ade
the
assu
mpt
ion
that
a fe
llow
wou
ld e
nter
HP
M tr
aini
ng w
ith a
bas
ic s
et o
f com
pete
ncie
s, a
llow
ing
the
fello
w to
fo
cus
on d
evel
opin
g sp
ecia
list-l
evel
HP
M c
ompe
tenc
ies.
Whi
le w
e an
ticip
ate
that
trai
nees
from
as
man
y as
ten
diffe
rent
sp
ecia
lties
, with
ten
diffe
rent
trai
ning
exp
erie
nces
, may
ent
er o
ur tr
aini
ng p
rogr
ams,
the
com
pete
ncie
s w
e pr
esen
t ass
ume
a ba
sic
foun
datio
n of
kno
wle
dge,
atti
tude
s, a
nd s
kills
for a
ll re
side
nts
ente
ring
an H
PM
trai
ning
pro
gram
.
Pre-
Com
pete
ncie
s Th
e fo
llow
ing
“pre
-com
pete
ncie
s” o
ught
to re
pres
ent t
he m
inim
um b
asic
ski
lls n
eces
sary
for e
ntra
nce
into
an
HP
M
train
ing
prog
ram
. A
lthou
gh H
PM
trai
ning
pro
gram
s, b
ased
on
thei
r res
ourc
es a
nd e
xper
tise,
may
mak
e di
ffere
nt d
ecis
ions
ab
out c
ompe
tenc
y ex
pect
atio
ns fo
r a tr
aine
e en
terin
g an
HP
M fe
llow
ship
, we
belie
ve th
at th
e fo
llow
ing
“pre
-co
mpe
tenc
ies”
are
ess
entia
l in
orde
r to
allo
w H
PM
trai
ning
pro
gram
s to
focu
s on
hel
ping
trai
nees
dev
elop
the
spec
ialis
t-le
vel c
ompe
tenc
ies
that
are
the
hallm
ark
of a
spe
cial
ist i
n th
e fie
ld:
A
bilit
y to
car
ry o
ut a
com
preh
ensi
ve a
nd a
ccur
ate
hist
ory
and
phys
ical
exa
min
atio
n
Abi
lity
to e
valu
ate
and
treat
com
mon
life
-thre
aten
ing
med
ical
illn
esse
s se
en in
adu
lts in
clud
ing
but n
ot li
mite
d to
he
art f
ailu
re, C
OP
D,
rena
l ins
uffic
ienc
y, c
irrho
sis,
stro
kes,
dia
bete
s an
d co
mm
on in
fect
ious
dis
ease
s.
A
bilit
y to
dev
elop
a d
iffer
entia
l dia
gnos
is fo
r com
mon
sym
ptom
s su
ch a
s dy
spne
a, p
ain,
cog
nitiv
e dy
sfun
ctio
n an
d co
mm
on la
b ab
norm
aliti
es ;
U
nder
stan
ding
of f
unda
men
tal k
now
ledg
e (e
.g.,
path
ophy
siol
ogy,
pha
rmac
olog
y, n
atur
al h
isto
ry, c
ompl
icat
ions
) re
late
d to
com
mon
life
-thre
aten
ing
illnes
ses
seen
in a
dults
Exp
erie
nce
in th
e lo
ngitu
dina
l, di
rect
pat
ient
car
e of
pat
ient
s w
ith a
wid
e va
riety
of c
ance
r and
non
-can
cer c
hron
ic
dise
ases
Bas
ic fa
milia
rity
with
evi
denc
e-ba
sed
med
icin
e
A
bilit
y to
acc
ess
and
criti
cally
read
the
med
ical
lite
ratu
re
B
asic
abi
lity
to c
ondu
ct o
pen-
ende
d, p
atie
nt c
ente
red
inte
rvie
ws
usin
g ap
prop
riate
faci
litat
ing
tech
niqu
es
H
ones
ty, i
nteg
rity,
resp
onsi
bilit
y, re
liabi
lity
B
asic
abi
lity
to s
elf-r
efle
ct
B
asic
und
erst
andi
ng o
f the
hea
lth c
are
syst
em
A
bilit
y to
col
labo
rate
with
oth
ers
in p
atie
nt c
are
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 3
Rev
ised
: 9/1
9/20
09
Com
pete
nt v
s. E
xper
t Th
e m
easu
rabl
e ou
tcom
es d
escr
ibed
in th
is d
ocum
ent r
epre
sent
thos
e fo
r the
min
imal
ly c
ompe
tent
spe
cial
ist p
allia
tive
care
phy
sici
an, n
ot th
e ex
pert.
Acc
ordi
ng to
the
Dre
yfus
mod
el o
f ski
ll ac
quis
ition
1 , “co
mpe
tenc
e” fa
lls m
idw
ay b
etw
een
the
novi
ce a
nd e
xper
t phy
sici
an.
Cha
ract
eris
tics
of c
ompe
tenc
e in
clud
e: b
eing
abl
e to
cop
e w
ith a
n ov
erw
helm
ing
num
ber o
f rul
es, t
hink
ing
ahea
d, s
eein
g th
e bi
gger
pic
ture
, dem
onst
ratin
g or
gani
zing
prin
cipl
es a
nd s
yste
mat
ic a
ppro
ache
s th
at d
iffer
dep
endi
ng o
n th
e si
tuat
ion,
pa
rtici
patin
g in
act
ive
deci
sion
-mak
ing,
and
feel
ing
a se
nse
of p
erso
nal r
espo
nsib
ility.
The
char
acte
ristic
s of
an
expe
rt pa
lliativ
e ca
re p
hysi
cian
– b
eing
abl
e to
imm
edia
tely
and
acc
urat
ely
asse
ss a
situ
atio
n,
intu
itive
ly s
eein
g ho
w to
dea
l with
it; u
sing
rule
s an
d gu
idel
ines
flex
ibly
; ana
lyzi
ng n
ew in
form
atio
n an
d pr
oble
ms
to a
rrive
at
sol
utio
ns; a
nd b
eing
abl
e to
exp
lain
clin
ical
reas
onin
g an
d de
cisi
on-m
akin
g –
deve
lop
only
ove
r tim
e an
d w
ith p
ract
ice.
The
mea
sura
ble
outc
omes
des
crib
ed in
this
doc
umen
t rep
rese
nt th
ose
for t
he m
inim
ally
qua
lifie
d sp
ecia
list p
allia
tive
care
ph
ysic
ian,
not
the
expe
rt. A
com
pete
nt p
hysi
cian
is c
apab
le o
f und
erta
king
inde
pend
ent p
ract
ice
and
cont
inue
s to
gro
w
tow
ards
pro
ficie
ncy
and
expe
rtise
.
Eval
uatio
n To
ols
We
inte
nd th
at th
is s
et o
f mea
sura
ble
outc
omes
and
sug
gest
ed e
valu
atio
n m
etho
ds b
e us
ed a
s a
reso
urce
doc
umen
t on
ly. T
he le
vel o
f det
ail i
s no
t pra
ctic
al fo
r com
preh
ensi
ve u
se. H
owev
er, i
t will
prov
ide
fello
wsh
ip d
irect
ors
with
gui
delin
esfo
r dev
elop
ing
and
impr
ovin
g ne
w a
nd e
xist
ing
educ
atio
n pr
ogra
ms.
Thi
s is
a w
ork
in p
rogr
ess
and
the
ultim
ate
end
prod
uct w
ill be
a s
et o
f eva
luat
ion
tool
s th
at w
ill m
easu
re th
e A
CG
ME
com
pete
ncie
s th
at a
re s
peci
fic to
HP
M.
1 Dre
yfus
’ mod
el o
f the
five
ste
ps o
f ski
ll ac
quis
ition
incl
udes
the
follo
win
g: n
ovic
e, a
dvan
ced
begi
nner
, com
pete
nt, p
rofic
ient
, exp
ert.
Bas
ed o
n D
reyf
us H
uber
t L, D
reyf
us S
tuar
t E, M
ind
over
Mac
hine
, ret
rieve
d fro
m th
e In
tern
et N
ov. 2
0, 2
006,
http
://w
3.m
si.v
xu.s
e/~p
er/C
P-
web
/PB
DD
SKIL
.HTM
HPM
Com
pete
ncie
s Pr
ojec
t Pha
se 2
Wor
k G
roup
Th
e fo
llow
ing
peop
le c
ontri
bute
d to
this
doc
umen
t:
Rob
ert A
rnol
d, M
.D.
Sec
tion
of P
allia
tive
Car
e &
Med
ical
Eth
ics
Uni
vers
ity o
f Pitt
sbur
gh M
edic
al S
choo
l M
UN
, 9W
, Pitt
sbur
gh, P
A 1
5213
-258
2 41
2- 6
92-4
888
rabo
b@pi
tt.ed
u
J. A
ndre
w B
illing
s, M
.D.
Mas
sach
uset
ts G
ener
al H
ospi
tal P
allia
tive
Car
e S
ervi
ce F
ND
600
, 55
Frui
t St.
Bos
ton,
MA
021
14
617-
724-
9197
jb
illing
s@pa
rtner
s.or
g
Sus
an D
. Blo
ck, M
.D.
Dan
a-Fa
rber
Can
cer I
nstit
ute
and
Brig
ham
an
d W
omen
's H
ospi
tal
44 B
inne
y S
treet
B
osto
n, M
A 0
2115
61
7- 6
32-6
179
sblo
ck@
partn
ers.
org
Nat
han
Gol
dste
in, M
.D.
Mou
nt S
inai
Sch
ool o
f Med
icin
e H
ertz
berg
Pal
liativ
e C
are
Inst
itute
O
ne G
usta
ve L
. Lev
y P
lace
, Box
107
0
New
Yor
k, N
Y 1
0029
21
2-24
1-14
46
nath
an.g
olds
tein
@m
ssm
.edu
Laur
a J.
Mor
rison
, M.D
. B
aylo
r Col
lege
of M
edic
ine
17
09 D
ryde
n, S
uite
850
H
oust
on, T
X 77
030
713-
798-
2285
lm
orris
o@bc
m.tm
c.ed
u
Tom
asz
Oko
n, M
.D.
Mar
shfie
ld C
linic
10
00 N
orth
Oak
Ave
nue
Mar
shfie
ld, W
I 54
449
715-
389-
4080
ok
on.to
mas
z@m
arsh
field
clin
ic.o
rg
San
dra
San
chez
-Rei
lly, M
.D.
Sou
th T
exas
Vet
eran
s H
ealth
Car
e S
yste
m
7400
Mer
ton
Min
ter
San
Ant
onio
, TX
782
29
210-
617-
5237
S
andr
a.S
anch
ez-R
eilly
@m
ed.v
a.go
v
Rod
ney
Tuck
er, M
.D.
Uni
vers
ity o
f Ala
bam
a at
Birm
ingh
am
Cen
ter f
or P
allia
tive
Car
e C
H19
219
U
1530
3rd
Ave
., S
outh
B
irmin
gham
, AL
352
94-2
041
rtuck
er@
agin
g.ua
b.ed
u
Jam
es T
ulsk
y, M
.D.
Cen
ter f
or P
allia
tive
Car
e
Duk
e U
nive
rsity
Med
ical
Cen
ter
Hoc
k P
laza
24
24 E
rwin
Roa
d, B
ox 1
105
D
urha
m, N
C 2
7705
919-
668-
2362
jtu
lsky
@du
ke.e
du
Cha
rles
von
Gun
ten,
M.D
., P
h.D
. S
an D
iego
Hos
pice
& P
allia
tive
Car
e
4311
Thi
rd A
ve
San
Die
go, C
A 9
2103
-140
7 61
9-27
8-62
25
cvon
gunt
en@
sdho
spic
e.or
g
Dav
id W
eiss
man
, M.D
. M
edic
al C
olle
ge o
f Wis
cons
in
9000
W. W
isco
nsin
Ave
M
ilwau
kee
WI 5
3226
41
4 80
5-46
07
dwei
ssm
a@m
cw.e
du
Dal
e Lu
pu, P
h.D
. A
mer
ican
Boa
rd o
f Hos
pice
and
Pal
liativ
e M
edic
ine
9200
Dal
evie
w C
t S
ilver
Spr
ing,
MD
209
01
301-
439-
8001
dl
upu@
abhp
m.o
rg
Judy
Opa
tik S
cott,
M.A
. A
mer
ican
Boa
rd o
f Hos
pice
& P
allia
tive
Med
icin
e 92
00 D
alev
iew
Ct
Silv
er S
prin
g, M
D 2
0901
30
1-43
9-80
01
opat
ik1@
aol.c
om
Rev
ised
: 9/1
9/20
09
List
of P
oten
tial A
sses
smen
t Met
hods
Use
d 1.
A
ttend
ing
phys
icia
n as
sess
men
t of f
ello
w
2.
Fello
w s
elf-a
sses
smen
t 3.
P
atie
nt a
sses
smen
t of f
ello
w
4.
Fam
ily a
sses
smen
t of f
ello
w
5.
Pee
r ass
essm
ent o
f fel
low
6.
Te
am a
sses
smen
t of f
ello
w7.
C
onsu
ltant
ass
essm
ent o
f fel
low
8.
Le
arne
r ass
essm
ent o
f fel
low
9.
M
ultip
le c
hoic
e ex
am (M
CE)
10.
Che
cklis
t eva
luat
ion
(e.g
. com
mun
icat
ion
skills
exe
rcis
e)
11.
Cha
rt/re
cord
revi
ew
12.
360
degr
ee e
valu
atio
n 13
. P
ortfo
lio
14.
Pra
ctic
e Im
prov
emen
t Mod
ule
(PIM
) 15
. G
loba
l rat
ing
scal
e 16
. C
hart-
stim
ulat
ed re
call
exam
inat
ion
17.
Obj
ectiv
e st
ruct
ured
clin
ical
exa
min
atio
n (O
SC
E)
18.
Sta
ndar
dize
d P
atie
nt (S
P)
19.
Min
i-CE
X
20.
Cas
e lo
g 21
. S
tand
ardi
zed
oral
exa
m
22.
Writ
ing
assi
gnm
ent (
e.g.
refle
ctiv
e es
say)
23
. A
ttend
ance
log
24.
Act
ivity
log
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 6
Patie
nt a
nd F
amily
Car
e C
ompe
tenc
y
Sub-
com
pete
ncy
Sam
ple
Beh
avio
r A
sses
smen
t M
etho
d 1.
1 G
athe
rs c
ompr
ehen
sive
and
ac
cura
te in
form
atio
n fro
m a
ll pe
rtine
nt s
ourc
es, i
nclu
ding
pa
tient
, fam
ily m
embe
rs, h
ealth
ca
re p
roxi
es, o
ther
hea
lth c
are
prov
ider
s, in
terd
isci
plin
ary
team
m
embe
rs a
nd m
edic
al re
cord
s
1.1.
1. O
btai
ns a
com
preh
ensi
ve m
edic
al h
isto
ry
and
phys
ical
exa
m, i
nclu
ding
: P
atie
nt u
nder
stan
ding
of i
llnes
s an
d pr
ogno
sis
Goa
ls o
f car
e/ad
vanc
e ca
re p
lann
ing/
prox
y de
cisi
on-m
akin
g D
etai
led
sym
ptom
his
tory
(inc
ludi
ng u
se o
f va
lidat
ed s
cale
s)
Psy
chos
ocia
l and
cop
ing
hist
ory
incl
udin
g lo
ss
hist
ory
Spi
ritua
l his
tory
F
unct
iona
l ass
essm
ent
Qua
lity
of li
fe a
sses
smen
t D
epre
ssio
n ev
alua
tion
(incl
udin
g st
ress
ors
and
area
s of
maj
or c
once
rn)
Pha
rmac
olog
ic h
isto
ry in
clud
ing
subs
tanc
e de
pend
ency
or a
buse
D
etai
led
neur
olog
ical
exa
m, i
nclu
ding
men
tal
stat
us e
xam
SP Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pat
ient
and
Fa
mily
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
1.1.
2 P
erfo
rms
dia
gnos
tic w
orku
p; re
view
s pr
imar
y so
urce
info
rmat
ion
and
eval
uatio
n; d
eter
min
es
prog
nosi
s an
d p
allia
tive
cour
se
Form
ulat
es a
pla
n of
car
e ba
sed
on a
vaila
ble
info
rmat
ion
and
prog
nosi
s
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
MC
E 1.
1.4
Util
izes
info
rmat
ion
tech
nolo
gy; a
cces
ses
on-
line
evid
ence
-bas
ed m
edic
ine
reso
urce
s; u
ses
elec
troni
c re
posi
torie
s of
info
rmat
ion,
and
med
ical
re
cord
s
Ope
rate
s el
ectro
nic
info
rmat
ion
reso
urce
s in
a fa
milia
r man
ner
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
1.2
Syn
thes
izes
and
app
lies
info
rmat
ion
in th
e cl
inic
al s
ettin
g 1.
2.1
Dev
elop
s a
prio
ritiz
ed d
iffer
entia
l dia
gnos
is
and
prob
lem
list
A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wC
hart/
reco
rd
revi
ew
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 7
Patie
nt a
nd F
amily
Car
e C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d 1.
2.2
Dev
elop
s re
com
men
datio
ns b
ased
on
patie
nt
and
fam
ily v
alue
s In
tegr
ates
pat
ient
’s a
nd/o
r fa
mily
’s v
alue
s in
to w
ritte
n go
als
of c
are
and
treat
men
t pl
an
360
Eva
luat
ion
Fam
ilyas
sess
men
t of
fello
w
1.2.
3 R
outin
ely
obta
ins
addi
tiona
l clin
ical
in
form
atio
n (fr
om o
ther
phy
sici
ans,
nur
ses,
ph
arm
acis
ts, s
ocia
l wor
kers
, cas
e m
anag
ers,
ch
apla
ins,
resp
irato
ry th
erap
ists
) whe
n ap
prop
riate
Col
lect
s in
form
atio
n fro
m o
ther
cl
inic
ians
whe
n ne
eded
36
0 E
valu
atio
n
1.3
Dem
onst
rate
s us
e of
the
inte
rdis
cipl
inar
y ap
proa
ch to
de
velo
p a
care
pla
n th
at
optim
izes
pat
ient
and
fam
ily
goal
s an
d re
duce
s su
fferin
g
360
Eva
luat
ion
Cha
rt/re
cord
re
view
1.4
Ass
esse
s an
d co
mm
unic
ates
pro
gnos
is
Iden
tifie
s an
d co
mm
unic
ates
pr
ogno
sis
accu
rate
ly
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
C
heck
list
eval
uatio
nev
alua
tion
Fam
ilyas
sess
men
t of
fello
w1.
5 A
sses
ses
and
man
ages
pa
tient
s w
ith th
e fu
ll sp
ectru
m o
f ad
vanc
ed, p
rogr
essi
ve, l
ife-
thre
aten
ing
cond
ition
s, in
clud
ing
com
mon
can
cers
, com
mon
non
-ca
ncer
dia
gnos
es, c
hron
ic
dise
ases
, and
em
erge
ncie
s
MC
E 36
0 E
valu
atio
n O
SC
E
1.6
Man
ages
phy
sica
l sy
mpt
oms,
psy
chol
ogic
al is
sues
, so
cial
stre
ssor
s, a
nd s
pirit
ual
1.6.
1 A
sses
ses
pain
and
non
-pai
n sy
mpt
oms
MC
E 36
0 E
valu
atio
n
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 8
Patie
nt a
nd F
amily
Car
e C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d as
pect
s of
the
patie
nt a
nd fa
mily
1.
6.2
Use
s op
ioid
and
non
-opi
oid
phar
mac
olog
ic
optio
ns
MC
E C
hart/
reco
rd
revi
ew
360
Eva
luat
ion
1.6.
3 U
ses
non-
phar
mac
olog
ic s
ympt
om
inte
rven
tions
MC
E C
hart/
reco
rd
revi
ew
360
Eva
luat
ion
1.6.
4 M
anag
es n
euro
psyc
hiat
ric d
isor
ders
M
CE
Cha
rt/re
cord
re
view
36
0 E
valu
atio
n 1.
6.5
Man
ages
phy
sica
l sym
ptom
s an
d ps
ycho
soci
al a
nd s
pirit
ual d
istre
ss in
the
patie
nt a
nd
fam
ily
MC
E C
hart/
reco
rd
revi
ew
360
Eva
luat
ion
1.6.
6 R
e-as
sess
es s
ympt
oms
frequ
ently
, and
m
akes
ther
apeu
tic a
djus
tmen
ts a
s ne
eded
36
0E
valu
atio
n
1.7
Coo
rdin
ates
, orc
hest
rate
s,
and
faci
litat
es k
ey e
vent
s in
pa
tient
car
e, s
uch
as fa
mily
m
eetin
gs, c
onsu
ltatio
n ar
ound
go
als
of c
are,
adv
ance
dire
ctiv
e co
mpl
etio
n, c
onfli
ct re
solu
tion,
w
ithdr
awal
of l
ife-s
usta
inin
g th
erap
ies,
and
pal
liativ
e se
datio
n, in
volv
ing
othe
r tea
m
mem
bers
as
appr
opria
te
Faci
litat
es w
ithdr
awal
of L
ST’s
ac
cord
ing
to re
cogn
ized
st
anda
rds
360
Eva
luat
ion
1.8
Pro
vide
s ca
re to
pat
ient
s an
d fa
milie
s th
at re
flect
s un
ique
ch
arac
teris
tics
of d
iffer
ent
setti
ngs
alon
g th
e pa
lliativ
e ca
re
spec
trum
1.8.
1 P
erfo
rms
pallia
tive
care
ass
essm
ent a
nd
man
agem
ent f
or th
e ho
me
visi
t, nu
rsin
g ho
me
visi
t, in
patie
nt h
ospi
ce u
nit v
isit,
out
patie
nt c
linic
vis
it, a
nd
hosp
ital p
atie
nt v
isit
360
Eva
luat
ion
1.8.
2 D
eliv
ers
timel
y an
d ac
cura
te in
form
atio
n an
d ad
dres
ses
barr
iers
to p
atie
nt a
nd fa
mily
acc
ess
to
360
Eva
luat
ion
Pt/F
amily
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 9
Patie
nt a
nd F
amily
Car
e C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d pa
lliativ
e ca
re in
mul
tiple
set
tings
as
sess
men
t of
fello
w1.
8.3
Wor
ks w
ith fa
milie
s in
an
inte
rdis
cipl
inar
y m
anne
r to
form
ulat
e d
isch
arge
pla
ns fo
r pat
ient
s an
d fa
milie
s
360
Eva
luat
ion
Pt/F
amily
asse
ssm
ent o
f fe
llow
1.9
Bas
es c
are
on p
atie
nt’s
pas
t hi
stor
y an
d pa
tient
and
fam
ily
pref
eren
ces
and
goal
s of
car
e,
prog
nost
ic in
form
atio
n, e
vide
nce,
cl
inic
al e
xper
ienc
e an
d ju
dgm
ent
1.9.
1 D
emon
stra
tes
a pa
tient
-fam
ily c
ente
red
appr
oach
to c
are
Pro
duce
s a
patie
nt a
nd fa
mily
-ce
nter
ed p
lan
of c
are
360
Eva
luat
ion
Fam
ilyas
sess
men
t of
fello
w
1.9.
2 M
akes
reco
mm
enda
tions
to c
onsu
lting
ph
ysic
ian(
s) a
s ap
prop
riate
Fo
rmul
ates
ade
quat
e pa
lliativ
e ca
re re
com
men
datio
ns; f
ollo
ws
appr
opria
te c
onsu
lt et
ique
tte
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Con
sulta
nt
asse
ssm
ent o
f fe
llow
1.10
Dem
onst
rate
s th
e ab
ility
to
resp
ond
to s
uffe
ring
thro
ugh
addr
essi
ng s
ourc
es o
f med
ical
an
d ps
ycho
soci
al/s
pirit
ual
dist
ress
, bea
ring
with
the
patie
nt’s
and
fam
ily’s
suf
ferin
g an
d di
stre
ss, a
nd re
mai
ning
a
pres
ence
, as
desi
red
by th
e pa
tient
and
fam
ily
360
Eva
luat
ion
Pt/F
amily
asse
ssm
ent o
f fe
llow
1.11
Dem
onst
rate
s ca
re th
at
show
s re
spec
tful a
ttent
ion
to
age/
deve
lopm
enta
l sta
ge,
gend
er, s
exua
l orie
ntat
ion,
cu
lture
, rel
igio
n/sp
iritu
ality
, as
wel
l as
fam
ily in
tera
ctio
ns a
nd
disa
bilit
y
Rec
ogni
zes
and
resp
ects
pa
tient
’s a
nd fa
mily
’s
uniq
uene
ss
360
Eva
luat
ion
Pt/F
amily
asse
ssm
ent o
f fe
llow
1.12
See
ks to
max
imiz
e pa
tient
s’ le
vel o
f fun
ctio
n, a
nd
1.12
.1 E
valu
ates
func
tiona
l sta
tus
over
tim
e U
ses
appr
opria
te to
ols
to
mea
sure
func
tiona
l sta
tus
360
Eva
luat
ion
Cha
rt/re
cord
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 10
Patie
nt a
nd F
amily
Car
e C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d qu
ality
of l
ife fo
r pat
ient
s an
d fa
milie
sre
view
1.12
.2 E
valu
ates
qua
lity
of li
fe o
ver t
ime
Doc
umen
ts q
ualit
y of
life
in
med
ical
cha
rt 36
0 E
valu
atio
n C
hart/
reco
rd
revi
ew
1.12
.3 P
rovi
des
expe
rtise
in m
axim
izin
g pa
tient
’s
leve
l of f
unct
ion
and
qual
ity o
f life
R
efer
s to
app
ropr
iate
ser
vice
s 36
0 E
valu
atio
n C
hart/
reco
rd
revi
ew
1.12
.4 S
eeks
to p
rese
rve
oppo
rtuni
ties
for
indi
vidu
al a
nd fa
mily
life
in th
e co
ntex
t of l
ife-
thre
aten
ing
illnes
s
360
Eva
luat
ion
Pt/F
amily
asse
ssm
ent o
f fe
llow
s1.
12.5
Rec
ogni
zes
the
pote
ntia
l val
ue to
pat
ient
s an
d th
eir f
amily
mem
bers
of c
ompl
etin
g pe
rson
al
affa
irs/u
nfin
ishe
d bu
sine
ss
Iden
tifie
s an
d fa
cilit
ates
op
portu
nitie
s to
reso
lve
unfin
ishe
d is
sues
360
Eva
luat
ion
1.12
.6 E
ffect
ivel
y m
anag
es p
hysi
cal s
ympt
oms
and
psyc
hoso
cial
and
spi
ritua
l dis
tress
in th
e pa
tient
and
fa
mily
360
Eva
luat
ion
MC
EC
hart/
reco
rd
revi
ew
1.13
Pro
vide
s pa
tient
and
fam
ily
educ
atio
n 1.
13.1
Edu
cate
s fa
milie
s in
mai
ntai
ning
and
im
prov
ing
leve
l of f
unct
ion
to m
axim
ize
qual
ity o
f life
36
0E
valu
atio
n
1.13
.2 E
xpla
ins
pallia
tive
care
ser
vice
s,
reco
mm
enda
tions
and
late
st d
evel
opm
ents
to
patie
nts
and
fam
ilies
360
Eva
luat
ion;
P
t/Fam
ilyas
sess
men
t of
fello
w1.
13.3
Edu
cate
s pa
tient
and
fam
ily a
bout
dis
ease
tra
ject
ory
and
how
and
whe
n to
acc
ess
pallia
tion
in
futu
re
360
Eva
luat
ion
1.14
Rec
ogni
zes
sign
s an
d sy
mpt
oms
of im
pend
ing
deat
h an
d ca
res
for t
he im
min
ently
dy
ing
patie
nt a
nd th
eir f
amily
m
embe
rs
1.14
.1 E
ffect
ivel
y pr
epar
es fa
mily
, oth
er h
ealth
car
e pr
ofes
sion
als,
and
car
egiv
ers
for t
he p
atie
nt’s
dea
th
Ade
quat
ely
inte
rpre
ts s
igns
of
impe
ndin
g de
ath
for o
ther
cl
inic
ians
and
fam
ily m
embe
rs
360
Eva
luat
ion;
P
t/Fam
ilyas
sess
men
t of
fello
w;
SP1.
14.2
Pro
vide
s as
sess
men
t and
sym
ptom
m
anag
emen
t for
the
imm
inen
tly d
ying
pat
ient
Id
entif
ies
trans
ition
to a
ctiv
ely
dyin
g an
d ch
ange
s m
anag
emen
t acc
ordi
ngly
360
Eva
luat
ion
M
CE
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 11
Patie
nt a
nd F
amily
Car
e C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d 1.
15P
rovi
des
treat
men
t to
the
bere
aved
1.
15.1
Pro
vide
s su
ppor
t to
fam
ily m
embe
rs a
t the
tim
e of
dea
th a
nd im
med
iate
ly a
fter
Dem
onst
rate
s co
mpa
ssio
n,
expr
esse
s co
ndol
ence
s,
expl
ores
fam
ily q
uest
ions
, and
pr
ovid
es in
form
atio
n a
s de
sire
d by
the
fam
ily
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n
1.15
.2 I
nvol
ves
inte
rdis
cipl
inar
y te
am m
embe
rs in
tre
atin
g th
e be
reav
ed
1.15
.3 R
efer
s fa
mily
mem
bers
to b
erea
vem
ent
prog
ram
s K
now
s av
aila
ble
com
mun
ity
reso
urce
s M
CE
360
Eva
luat
ion
1.16
Ref
ers
patie
nts
and
fam
ily
mem
bers
to o
ther
hea
lth c
are
prof
essi
onal
s to
ass
ess,
trea
t an
d m
anag
e pa
tient
and
fam
ily
care
issu
es o
utsi
de th
e sc
ope
of
pallia
tive
care
pra
ctic
e an
d co
llabo
rate
s ef
fect
ivel
y w
ith th
em
1.16
.1 R
ecog
nize
s th
e ne
ed fo
r col
labo
ratio
n w
ith
clin
icia
ns p
rovi
ding
dis
ease
-mod
ifyin
g tre
atm
ent
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Fello
w s
elf-
asse
ssm
ent
Con
sulta
nt
asse
ssm
ent o
f fe
llow
1.16
.2 C
olla
bora
tes
with
and
mak
es re
ferr
als
to
pedi
atric
ians
with
exp
ertis
e re
leva
nt to
the
care
of
child
ren
with
adv
ance
d, p
rogr
essi
ve, a
nd li
fe-
thre
aten
ing
illnes
s
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
;C
onsu
ltant
as
sess
men
t of
fello
w1.
16.3
Acc
esse
s sp
ecia
lized
ped
iatri
c an
d ge
riatri
c pa
lliativ
e ca
re re
sour
ces
appr
opria
tely
A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w1.
16.4
Col
labo
rate
s w
ith o
ther
men
tal h
ealth
cl
inic
ians
to m
eet t
he n
eeds
of p
atie
nts
with
maj
or
men
tal h
ealth
issu
es
Inte
grat
es m
enta
l hea
lth
clin
icia
ns’ r
ecom
men
datio
ns
into
pat
ient
s’ p
lan
of c
are
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
;
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 12
Patie
nt a
nd F
amily
Car
e C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d C
onsu
ltant
as
sess
men
t of
fello
w
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 13
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y Sa
mpl
e B
ehav
ior
Ass
essm
ent
Met
hod
2.1
Des
crib
es th
e sc
ope
and
prac
tice
of
hosp
ice
and
pallia
tive
med
icin
e, in
clud
ing:
Dom
ains
of h
ospi
ce a
nd p
allia
tive
care
Rol
e of
pal
liativ
e ca
re in
co-
man
agem
ent o
f pat
ient
s w
ith p
oten
tially
life
-lim
iting
illn
ess
at a
ll st
ages
of
dise
ase
and
in th
e pr
esen
ce
of re
stor
ativ
e, c
urat
ive,
and
lif
e-pr
olon
ging
goa
ls
His
tory
of h
ospi
ce a
nd p
allia
tive
med
icin
e
Set
tings
whe
re h
ospi
ce a
nd p
allia
tive
care
are
pro
vide
d
Ele
men
ts o
f pat
ient
ass
essm
ent a
nd
man
agem
ent a
cros
s di
ffere
nt h
ospi
ce a
nd
pallia
tive
care
set
tings
, inc
ludi
ng h
ome
visi
t, nu
rsin
g ho
me
visi
t, in
patie
nt h
ospi
ce
unit
visi
t, ou
tpat
ient
clin
ic v
isit,
and
in
hosp
ital p
atie
nt v
isit.
Iden
tifie
s pa
lliativ
e ca
re d
omai
ns
that
cou
ld b
e ad
dres
sed
for a
ny
patie
nt w
ith p
oten
tially
life
-lim
iting
illn
ess
at a
ll st
ages
of d
isea
se a
nd in
th
e se
tting
of a
ll ot
her a
ppro
pria
te
ther
apie
s
Rec
alls
pro
fess
iona
l bac
kgro
und
of
Cic
ely
Sau
nder
s, th
e na
me
of h
er
hosp
ice
prog
ram
, and
the
year
it
was
est
ablis
hed
Iden
tifie
s ye
ar o
f est
ablis
hmen
t of
Hos
pice
Med
icar
e B
enef
it, it
s m
ajor
fe
atur
es, a
nd it
s si
gnifi
canc
e in
the
hist
ory
of h
ospi
ce in
the
U.S
.
Dem
onst
rate
s ap
prop
riate
pr
epar
atio
n fo
r hom
e vi
sit
Pre
pare
s ap
prop
riate
dis
char
ge p
lan
for c
ompl
ex in
patie
nts,
car
ries
out o
r as
sure
s al
l rel
ated
task
s, a
nd
assu
res
good
follo
w-u
p
Ass
esse
s co
mpl
ianc
e in
the
ambu
lato
ry s
ettin
g an
d us
es h
ome
serv
ices
to p
rom
ote
and
furth
er
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E O
SC
E A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
MC
E
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E
360
Eva
luat
ion
360
Eva
luat
ion
Cha
rt/re
cord
re
view
O
SC
E P
eer
asse
ssm
ent o
f fe
llow
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 14
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
The
Med
icar
e/M
edic
aid
Hos
pice
Ben
efit,
in
clud
ing
esse
ntia
l ele
men
ts o
f the
pr
ogra
m, e
ligib
ility,
and
key
regu
latio
ns
for a
ll le
vels
of h
ospi
ce c
are
Bar
riers
face
d by
pat
ient
s an
d fa
mili
es in
ac
cess
ing
hosp
ice
and
pallia
tive
care
se
rvic
es
asse
ss c
ompl
ianc
e.
Des
crib
es e
ssen
tial e
lem
ents
and
el
igib
ility
crite
ria fo
r hos
pice
Cor
rect
ly e
valu
ates
pat
ient
s fo
r the
ir ho
spic
e el
igib
ility
and
appr
opria
tene
ss fo
r a v
arie
ty o
f ho
spic
e le
vels
of c
are
In e
valu
atin
g pa
tient
s an
d fa
milie
s fo
r hos
pice
, ide
ntifi
es p
sych
olog
ical
, so
cial
, eco
nom
ic, a
nd o
ther
bar
riers
to
acc
essi
ng h
ospi
ce
360
Eva
luat
ion
Cha
rt/re
cord
re
view
P
eer
asse
ssm
ent o
f fe
llow
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
wO
SC
E
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n O
SC
E 2.
2 R
ecog
nize
s th
e ro
le o
f the
in
terd
isci
plin
ary
team
in h
ospi
ce a
nd
pallia
tive
care
2.2.
1 D
escr
ibes
the
role
of t
he p
allia
tive
care
ph
ysic
ian
in th
e in
terd
isci
plin
ary
team
Id
entif
ies
the
role
s pe
rform
ed b
y a
phys
icia
n on
a p
artic
ular
team
and
ev
alua
tes
this
in te
rms
of th
e po
tent
ial r
ange
of r
oles
that
ph
ysic
ians
can
pla
y
Sta
ndar
dize
d or
al e
xam
inat
ion
A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wP
eer
asse
ssm
ent o
f fe
llow
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 15
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
360
Eva
luat
ion
2.2.
2 Id
entif
ies
the
vario
us m
embe
rs o
f the
in
terd
isci
plin
ary
team
and
thei
r rol
es a
nd
resp
onsi
bilit
ies
Des
crib
es th
e ac
tual
role
of v
ario
us
clin
icia
ns o
n a
team
and
eva
luat
es
thei
r beh
avio
rs in
term
s of
the
pote
ntia
l rol
es th
ey c
an p
lay
Iden
tifie
s be
havi
ors
that
faci
litat
e an
d hi
nder
team
func
tion
Sta
ndar
dize
d or
al e
xam
inat
ion
Sta
ndar
dize
d or
al e
xam
inat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n
2.2.
3 R
ecog
nize
s ho
w a
nd w
hen
to c
olla
bora
te
with
oth
er a
llied
heal
th p
rofe
ssio
nals
, suc
h as
nu
tritio
nist
s, p
hysi
cal t
hera
pist
s, re
spira
tory
th
erap
ists
, occ
upat
iona
l the
rapi
sts,
spe
ech
ther
apis
ts, a
nd c
ase
man
ager
s
Dem
onst
rate
s ap
prop
riate
refe
rral t
o al
lied
heal
th p
rofe
ssio
nals
in
form
ulat
ing
and
carr
ying
out
a c
are
plan
.
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n 2.
2.4
Des
crib
es c
once
pts
of te
am p
roce
ss a
nd
reco
gniz
es p
sych
osoc
ial a
nd o
rgan
izat
iona
l el
emen
ts th
at p
rom
ote
or h
inde
r suc
cess
ful
inte
rdis
cipl
inar
y te
am fu
nctio
n
Des
crib
es te
am p
roce
sses
evi
dent
in
a te
am m
eetin
g
Rec
ogni
zes
psyc
hoso
cial
and
or
gani
zatio
nal e
lem
ents
that
pr
omot
e or
hin
der s
ucce
ssfu
l in
terd
isci
plin
ary
team
func
tion
in a
cl
inic
al s
ettin
g, a
nd th
en c
onst
ruct
s
Sta
ndar
dize
d or
al e
xam
inat
ion
W
ritin
gas
sign
men
t
Sta
ndar
dize
d or
al e
xam
inat
ion
Writ
ing
assi
gnm
ent
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 16
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
a pl
an to
faci
litat
e m
ore
faci
litat
ing
beha
vior
s
Dem
onst
rate
s ap
prop
riate
beh
avio
rs
and
faci
litat
ing
of te
am p
roce
ss in
te
am m
eetin
gs a
nd in
form
al
cont
acts
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n 2.
3 D
escr
ibes
how
to a
sses
s an
d co
mm
unic
ate
prog
nosi
s 2.
3.1
Iden
tifie
s w
hat e
lem
ents
of t
he p
atie
nt’s
hi
stor
y an
d ph
ysic
al e
xam
inat
ion
are
criti
cal t
o fo
rmul
atin
g pr
ogno
sis
for a
giv
en p
atie
nt
In e
valu
atin
g pa
tient
s, id
entif
ies
key
elem
ents
(his
tory
, phy
sica
l ex
amin
atio
n, a
nd la
bora
tory
) tha
t ar
e us
eful
in p
rogn
ostic
atio
n.
Cha
rt/re
cord
re
view
S
tand
ardi
zed
oral
exa
min
atio
n O
SC
E SP W
ritin
gas
sign
men
t 2.
3.2
Des
crib
es c
omm
on c
hron
ic il
lnes
ses
with
pr
ogno
stic
fact
ors,
exp
ecte
d na
tura
l cou
rse
and
traje
ctor
ies,
com
mon
trea
tmen
ts, a
nd
com
plic
atio
ns
For c
ance
r, he
art f
ailu
re, d
emen
tia,
and
anox
ic o
r tra
umat
ic b
rain
inju
ry,
desc
ribes
the
key
prog
nost
ic fa
ctor
s fo
r sev
ere
disa
bilit
y or
dea
th a
nd
form
ulat
es a
pro
gnos
is
For c
omm
on c
ance
rs a
t typ
ical
ly
incu
rabl
e st
ages
, de
scrib
es th
e m
ean
surv
ival
for t
reat
ed a
nd
untre
ated
dis
ease
Des
crib
es m
ajor
mod
aliti
es o
f tre
atm
ent f
or m
etas
tatic
can
cer,
cong
estiv
e he
art f
ailu
re, c
hron
ic
obst
ruct
ive
lung
dis
ease
, ALS
, and
de
men
tias,
and
is a
ble
to a
pply
this
kn
owle
dge
to o
utlin
e ca
re o
ptio
ns fo
r
MC
E S
tand
ardi
zed
oral
exa
min
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wO
SC
E
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 17
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
spec
ific
clin
ical
cas
es
Rec
ogni
zes
com
mon
sid
e ef
fect
s of
ch
emot
hera
py a
gent
s an
d bi
olog
ical
s, a
nd is
abl
e to
des
crib
e th
ese
to p
atie
nts
and
fam
ily
mem
bers
Des
crib
es k
ey c
linic
al fe
atur
es a
nd
is a
ble
to r
ecog
nize
maj
or a
nd
urge
nt c
ance
r com
plic
atio
ns, s
uch
as c
ord
com
pres
sion
, sup
erio
r ven
a ca
va s
yndr
ome,
hyp
erca
lcem
ia,
hypo
natre
mia
Sta
ndar
dize
d or
al e
xam
inat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
wS
tand
ardi
zed
oral
exa
min
atio
n
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
wSP O
SC
E M
CE
2.3.
3 D
escr
ibes
effe
ctiv
e st
rate
gies
to
com
mun
icat
e pr
ogno
stic
info
rmat
ion
to p
atie
nts,
fa
milie
s an
d he
alth
car
e pr
ovid
ers
Use
s cl
inic
al d
ata
to c
onst
ruct
a
prog
nosi
s, a
nd th
en c
omm
unic
ates
th
is p
rogn
osis
to a
pat
ient
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP2.
4 R
ecog
nize
s th
e pr
esen
tatio
n an
d m
anag
emen
t of c
omm
on c
ance
rs, i
nclu
ding
2.
4.1
Iden
tifie
s co
mm
on d
iagn
ostic
and
tre
atm
ent m
etho
ds in
the
initi
al e
valu
atio
n an
d In
a v
arie
ty o
f clin
ical
situ
atio
ns in
w
hich
met
asta
tic d
isea
se is
A
ttend
ing
phys
icia
n
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 18
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
thei
r epi
dem
iolo
gy, e
valu
atio
n, p
rogn
osis
, tre
atm
ent,
patte
rns
of a
dvan
ced
or
met
asta
tic d
isea
se, e
mer
genc
ies,
co
mpl
icat
ions
, ass
ocia
ted
sym
ptom
s, a
nd
sym
ptom
atic
trea
tmen
ts
ongo
ing
man
agem
ent o
f can
cer
su
spec
ted,
des
crib
es ty
pica
l di
agno
stic
effo
rts to
con
firm
the
diag
nosi
s.
In a
var
iety
of c
linic
al s
ituat
ions
in
whi
ch m
etas
tatic
dis
ease
is
dem
onst
rate
d, s
ugge
sts
appr
opria
te
treat
men
t opt
ions
.
asse
ssm
ent o
f fe
llow
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
2.4.
2 Id
entif
ies
com
mon
ele
men
ts in
pr
ogno
stic
atio
n fo
r sol
id tu
mor
s an
d he
mat
olog
ical
mal
igna
ncie
s at
var
ious
sta
ges,
in
clud
ing
the
natu
ral h
isto
ry o
f unt
reat
ed
canc
ers
For c
omm
on c
ance
rs a
t var
ious
st
ages
, dis
tingu
ishe
s po
tent
ially
cu
rabl
e fro
m in
cura
ble
dise
ase,
and
de
scrib
es th
e pr
ogno
sis
for t
reat
ed
and
untre
ated
dis
ease
Use
s pr
ogno
stic
info
rmat
ion
appr
opria
tely
in d
iscu
ssin
g di
agno
stic
and
trea
tmen
t opt
ions
w
ith p
atie
nts
and
fam
ilies.
MC
E S
tand
ardi
zed
oral
exa
min
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w2.
4.3
Des
crib
es p
atte
rns
of a
dvan
ced
dise
ase,
as
soci
ated
sym
ptom
s, a
nd s
ympt
omat
ic
treat
men
ts fo
r com
mon
can
cers
Dem
onst
rate
s fa
milia
rity
with
the
com
mon
pat
tern
s of
met
asta
tic
dise
ase
and
asso
ciat
ed s
ympt
oms
for a
dvan
ced
ovar
ian
canc
er
Dem
onst
rate
s fa
milia
rity
with
co
mm
on p
atte
rns
of s
prea
d of
co
mm
on m
etas
tatic
can
cers
, suc
h
MC
E S
tand
ardi
zed
oral
exa
min
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 19
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
as c
olon
ic c
arci
nom
a
For c
omm
on s
ympt
oms
of a
dvan
ced
canc
er, f
orm
ulat
es a
diff
eren
tial
diag
nosi
s of
the
etio
logy
and
of
appr
opria
te d
iagn
ostic
effo
rts to
de
linea
te th
e et
iolo
gy.
For c
omm
on p
rese
ntin
g sy
mpt
oms
of a
dvan
ced
canc
er (e
.g, p
rost
ate
canc
er) d
escr
ibes
sym
ptom
atic
tre
atm
ent
MC
E S
tand
ardi
zed
oral
exa
min
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
MC
E S
tand
ardi
zed
oral
exa
min
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
Sta
ndar
dize
d or
al e
xam
inat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
2.4.
4 D
escr
ibes
the
pres
enta
tion
and
man
agem
ent o
f com
mon
com
plic
atio
ns o
f m
alig
nanc
y, i.
e. h
yper
calc
emia
and
bra
in
met
asta
ses,
and
em
erge
ncie
s, i.
e. s
eizu
res
and
hem
orrh
age
For a
pat
ient
with
met
asta
tic b
reas
t ca
ncer
and
new
ons
et o
f sev
ere
back
pai
n, d
emon
stra
tes
an
awar
enes
s of
the
poss
ibilit
y of
ep
idur
al c
ord
com
pres
sion
, it's
di
agno
sis,
and
ear
ly tr
eatm
ent
Adv
ises
a p
atie
nt w
ith a
can
cer
met
asta
tic to
the
brai
n, a
s w
ell a
s th
e fa
mily
, abo
ut th
e em
erge
ncy
man
agem
ent o
f sei
zure
s
Sta
ndar
dize
d or
al e
xam
inat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
2.5
Rec
ogni
zes
the
pres
enta
tion
and
man
agem
ent o
f com
mon
non
-can
cer l
ife-
2.5.
1 Id
entif
ies
mar
kers
of a
dvan
ced
dise
ase
in
com
mon
non
-can
cer l
ife-th
reat
enin
g co
nditi
ons,
In
ana
lyzi
ng th
e pr
esen
ting
clin
ical
da
ta fo
r pat
ient
s w
ith a
var
iety
of
MC
E S
tand
ardi
zed
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 20
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
thre
aten
ing
cond
ition
s, in
clud
ing
thei
r ep
idem
iolo
gy, e
valu
atio
n, p
rogn
osis
, tre
atm
ent,
patte
rns
of d
isea
se p
rogr
essi
on,
com
plic
atio
ns, e
mer
genc
ies,
ass
ocia
ted
sym
ptom
s, a
nd s
ympt
omat
ic tr
eatm
ents
such
as
cong
estiv
e he
art f
ailu
re, c
hron
ic
obst
ruct
ive
pulm
onar
y di
seas
e, a
nd d
emen
tia
non-
canc
er li
fe-th
reat
enin
g co
nditi
ons,
form
ulat
es a
pro
gnos
is
and
elig
ibilit
y fo
r hos
pice
oral
exa
min
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
2.5.
2 D
escr
ibes
pat
tern
s of
adv
ance
d di
seas
e,
asso
ciat
ed s
ympt
oms,
(i.e
. dys
pnea
for
cong
estiv
e he
art f
ailu
re a
nd d
ysph
agia
for
dem
entia
), an
d sy
mpt
omat
ic tr
eatm
ents
for
com
mon
non
-can
cer l
ife-th
reat
enin
g co
nditi
ons
Iden
tifie
s co
mm
on s
ympt
oms
of
adva
nced
gas
tric
canc
er
and
desc
ribes
sym
ptom
atic
tre
atm
ent.
Pro
vide
s a
com
preh
ensi
ve
eval
uatio
n fo
r the
sym
ptom
s as
soci
ated
with
hyp
erca
lcem
ia a
nd
pres
crib
es a
ppro
pria
te tr
eatm
ent
Sta
ndar
dize
d or
al e
xam
inat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
OS
CE
2.5.
3 D
escr
ibes
the
pres
enta
tion
and
man
agem
ent o
f com
mon
com
plic
atio
ns o
f non
-ca
ncer
life
-thre
aten
ing
cond
ition
s, i.
e.
pulm
onar
y ed
ema
and
psyc
hosi
s, a
nd
emer
genc
ies,
i.e.
myo
card
ial i
nfar
ctio
n fo
r co
rona
ry a
rtery
dis
ease
and
stro
ke fo
r ce
rebr
ovas
cula
r dis
ease
Pro
vide
s a
com
preh
ensi
ve
eval
uatio
n of
adv
ance
d ch
roni
c lu
ng
dise
ase,
and
pre
scrib
es o
r sug
gest
s ap
prop
riate
man
agem
ent,
incl
udin
g pr
epar
atio
n fo
r dea
ling
with
like
ly
sign
s of
det
erio
ratio
n or
the
need
for
emer
genc
y ca
re
Sta
ndar
dize
d or
al e
xam
inat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
2.6
Exp
lain
s pr
inci
ples
of a
sses
sing
pai
n an
d ot
her c
omm
on n
on-p
ain
sym
ptom
s 2.
6.1
Des
crib
es th
e co
ncep
t of “
tota
l pai
n”
Pro
vide
s a
com
preh
ensi
ve a
naly
sis
of p
atie
nts
with
pai
n an
d id
entif
ies
the
phys
ical
, psy
chos
ocia
l, an
d
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 21
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
spiri
tual
com
pone
nts
of d
istre
ss
fello
wC
hart/
reco
rd
revi
ew
2.6.
2 E
xpla
ins
the
rele
vant
bas
ic s
cien
ce,
path
ophy
siol
ogy,
ass
ocia
ted
sym
ptom
s an
d si
gns,
and
dia
gnos
tic o
ptio
ns u
sefu
l in
diffe
rent
iatin
g am
ong
diffe
rent
etio
logi
es o
f pai
n an
d no
n-pa
in s
ympt
oms
Eva
luat
es p
atie
nts
with
pai
n an
d ot
her n
on-p
ain
sym
ptom
s, a
nd
diffe
rent
iate
s am
ong
poss
ible
et
iolo
gies
.
Des
crib
es c
omm
on fe
atur
es o
f pai
n an
d no
n-pa
in s
ympt
oms
that
su
gges
t par
ticul
ar e
tiolo
gies
, and
di
stin
guis
hes
and
iden
tifie
s us
eful
di
agno
stic
opt
ions
to c
larif
y th
e et
iolo
gy
Des
crib
es th
e ba
sic
scie
nce
and
path
ophy
siol
ogy
of c
omm
on p
ain
and
non-
pain
sym
ptom
s
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
OS
CE
MC
E
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
OS
CE
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
OS
CE
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 2.
6.3
Des
crib
es a
thor
ough
ass
essm
ent a
nd
func
tiona
l sta
tus
of p
ain
and
othe
r sym
ptom
s,
incl
udin
g th
e us
e of
app
ropr
iate
dia
gnos
tic
met
hods
and
sym
ptom
mea
sure
men
t too
ls
In e
valu
atin
g pa
tient
s, d
emon
stra
tes
an a
bilit
y to
ass
ess
and
appr
opria
tely
man
age
pain
and
ot
her s
ympt
oms
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
2.6.
4 N
ames
com
mon
pat
ient
, fam
ily, h
ealth
In
eva
luat
ing
patie
nts,
iden
tifie
s an
d A
ttend
ing
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 22
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
care
pro
fess
iona
l, an
d he
alth
car
e sy
stem
ba
rrier
s to
the
effe
ctiv
e tre
atm
ent o
f sym
ptom
s
addr
esse
s co
mm
on b
arrie
rs to
ef
fect
ive
treat
men
t, su
ch a
s fe
ars
of
addi
ctio
n an
d to
lera
nce,
diff
icul
ties
with
adh
erin
g to
com
plic
ated
m
edic
atio
n sc
hedu
les,
dis
com
fort
with
intim
ate
bodi
ly c
onta
ct o
r ex
posu
re, a
nd in
abilit
y to
man
age
such
com
plex
ski
lls a
s dr
essi
ng
chan
ges,
inse
rting
rect
al
supp
osito
ries,
or a
dmin
istra
ting
IV
fluid
s
phys
icia
n as
sess
men
t of
fello
wSt
anda
rdiz
ed
oral
exa
min
atio
n
2.7
Des
crib
es th
e us
e of
opi
oids
in p
ain
and
non-
pain
sym
ptom
man
agem
ent
2.7.
1 L
ists
the
indi
catio
ns, c
linic
al
phar
mac
olog
y, a
ltern
ate
rout
es, e
quia
nalg
esic
co
nver
sion
s, a
ppro
pria
te ti
tratio
n, to
xici
ties,
and
m
anag
emen
t of c
omm
on s
ide
effe
cts
for o
pioi
ds
Dem
onst
rate
s an
abi
lity
to c
orre
ctly
pr
escr
ibe
opio
ids
for p
ain
and
non-
pain
sym
ptom
man
agem
ent i
n a
varie
ty o
f set
tings
, inc
ludi
ng c
hoic
e of
rout
e, d
osag
e, in
terv
als,
ste
ps in
tit
ratio
n, a
nd p
reve
ntio
n an
d m
anag
emen
t of s
ide
effe
cts
and
toxi
city
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E
2.7.
2 D
escr
ibes
app
ropr
iate
opi
oid
pres
crib
ing,
m
onito
ring
of tr
eatm
ent o
utco
mes
, and
toxi
city
m
anag
emen
t in
chro
nic,
urg
ent a
nd e
mer
genc
y pa
in c
ondi
tions
.
For a
pat
ient
with
poo
rly c
ontro
lled
pain
on
acet
amin
ophe
n, c
hoos
es
the
appr
opria
te a
dditi
onal
pai
n m
edic
atio
n an
d do
sage
, ref
lect
ing
an a
war
enes
s of
the
etio
logy
of t
he
pain
, it's
sev
erity
, ris
ks o
f tox
icity
, an
d ap
prop
riate
mon
itorin
g an
d fo
llow
-up
For a
pat
ient
on
chro
nic
oral
m
etha
done
for a
bdom
inal
and
bac
k pa
in a
ssoc
iate
d w
ith m
etas
tatic
pa
ncre
atic
can
cer w
ho n
ow is
un
able
to ta
ke p
ills b
ecau
se o
f
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 23
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
seve
re n
ause
a an
d vo
miti
ng,
pres
crib
es a
n ap
prop
riate
regi
men
of
mor
phin
e or
hyd
rom
orph
one,
ad
min
iste
red
via
patie
nt c
ontro
lled
anal
gesi
a
2.7.
3 D
escr
ibes
app
ropr
iate
opi
oid
pres
crib
ing
in d
iffer
ent c
linic
al c
are
set
tings
: hom
e,
resi
dent
ial h
ospi
ce, h
ospi
tal,
long
-term
car
e fa
cilit
y
For a
pat
ient
on
a co
mpl
ex
anal
gesi
c re
gim
en a
nd b
eing
di
scha
rged
to a
nur
sing
hom
e fro
m a
ho
spita
l, pr
escr
ibes
an
appr
opria
te
anal
gesi
c re
gim
en th
at is
sui
tabl
e fo
r th
is n
ew s
ettin
g
In c
hoos
ing
an o
pioi
d re
gim
en fo
r a
patie
nt in
hos
pice
, pre
scrib
es
med
icat
ions
in a
man
ner t
hat
dem
onst
rate
s aw
aren
ess
of s
uch
issu
es a
s co
st, c
onve
nien
ce,
avai
labi
lity,
and
com
plia
nce
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
2.7.
4 D
escr
ibes
the
conc
epts
of a
ddic
tion,
ps
eudo
addi
ctio
n, d
epen
denc
e an
d to
lera
nce,
an
d de
scrib
es th
eir s
igni
fican
ce in
pai
n m
anag
emen
t, as
wel
l as
appr
oach
es to
m
anag
ing
pain
in p
atie
nts
with
cur
rent
or p
rior
subs
tanc
e ab
use
For a
pat
ient
in th
e re
cove
ry fr
om
opio
id a
buse
and
now
with
pai
n fro
m
wid
ely
met
asta
tic b
ony
met
asta
sis,
co
unse
ls th
e pa
tient
abo
ut th
e ris
ks
of th
e de
pend
ence
and
tole
ranc
e,
the
impo
rtanc
e of
goo
d an
alge
sia
and
a re
gim
en th
at a
llow
s fo
r car
eful
m
onito
ring
whi
le m
inim
izin
g th
e ris
k of
add
ictio
n
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
SP
2.7.
5 E
xpla
ins
the
lega
l and
regu
lato
ry is
sues
su
rrou
ndin
g op
ioid
pre
scrib
ing
Writ
es o
pioi
d pr
escr
iptio
ns th
at
refle
ct a
n aw
aren
ess
of p
ertin
ent
lega
l and
regu
lato
ry is
sues
, in
clud
ing
the
amou
nt p
resc
ribed
, m
anag
ing
incr
ease
s in
dos
age
betw
een
pres
crip
tions
, and
the
need
fo
r writ
ten
pres
crip
tions
for r
efills
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 24
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
SP2.
8 D
escr
ibes
the
use
of n
on-o
pioi
d an
alge
sics
, adj
uvan
t ana
lges
ics,
and
oth
er
phar
mac
olog
ic a
ppro
ache
s to
the
man
agem
ent o
f bot
h pa
in a
nd n
on-p
ain
sym
ptom
s
2.8.
1 Id
entif
ies
the
indi
catio
ns, c
linic
al
phar
mac
olog
y, a
ltern
ate
rout
es, a
ppro
pria
te
titra
tion,
toxi
citie
s, a
nd m
anag
emen
t of c
omm
on
side
effe
cts
for:
acet
amin
ophe
n, a
spiri
n,
NS
AID
s, c
ortic
oste
roid
s, a
ntic
onvu
lsan
ts, a
nti-
depr
essa
nts,
and
loca
l ane
sthe
tics
used
in th
e tre
atm
ent o
f pai
n an
d no
n-pa
in s
ympt
oms.
Rec
ogni
zes
neur
opat
hic
pain
and
co
rrec
tly p
resc
ribes
ant
icon
vuls
ants
or
ant
idep
ress
ants
Cor
rect
ly d
escr
ibes
the
use
of n
on-
opio
id a
nalg
esic
s, th
eir c
omm
on
toxi
citie
s, c
ontra
indi
catio
ns, a
nd h
ow
they
are
pre
scrib
ed
In p
resc
ribin
g co
rtico
ster
oids
at l
ow
dose
s fo
r pai
n, id
entif
ies
addi
tiona
l be
nefic
ial a
nd h
arm
ful e
ffect
s
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
2.9
Des
crib
es p
harm
acol
ogic
app
roac
hes
to
the
man
agem
ent o
f com
mon
non
-pai
n sy
mpt
oms
2.9.
1 D
escr
ibes
use
of c
omm
on a
gent
s us
ed to
tre
at d
yspn
ea, n
ause
a, v
omiti
ng, d
iarrh
ea,
cons
tipat
ion,
anx
iety
, dep
ress
ion,
fatig
ue,
prur
itus,
con
fusi
on, a
gita
tion,
and
oth
er
com
mon
pro
blem
s in
pal
liativ
e ca
re p
ract
ice
Des
crib
es a
clin
ical
app
roac
h to
m
anag
ing
naus
ea a
nd v
omiti
ng
refra
ctor
y to
com
mon
age
nts,
in
clud
ing
the
utilit
y of
var
ious
di
agno
stic
effo
rts
In e
valu
atin
g pa
tient
s w
ith d
eliri
um,
prov
ides
a c
ompr
ehen
sive
di
ffere
ntia
l dia
gnos
is b
ased
on
hist
ory,
phy
sica
l exa
min
atio
n, a
nd
labo
rato
ry te
sts,
and
cor
rect
ly
pres
crib
es tr
eatm
ents
aim
ed a
t the
et
iolo
gy o
f the
del
irium
or a
t the
sy
mpt
om, i
nclu
ding
bot
h ph
arm
acol
ogic
al a
nd
nonp
harm
acol
ogic
al tr
eatm
ents
Cor
rect
ly d
iagn
osis
and
pre
scrib
es
treat
men
t for
sm
all b
owel
ob
stru
ctio
n, in
clud
ing
surg
ical
ap
proa
ches
, pha
rmac
olog
ical
ap
proa
ches
, and
cou
nsel
ing
of th
e pa
tient
and
fam
ily
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 25
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
In e
valu
atin
g a
lung
can
cer p
atie
nt
with
new
ons
et d
yspn
ea, d
escr
ibes
a
diffe
rent
ial d
iagn
osis
, eva
luat
ion
plan
, and
firs
t-lin
e tre
atm
ents
for
vario
us e
tiolo
gies
2.9.
2 Id
entif
ies
the
indi
catio
ns, c
linic
al
phar
mac
olog
y, a
ltern
ate
rout
es, a
ppro
pria
te
titra
tion,
toxi
citie
s, a
nd m
anag
emen
t of c
omm
on
side
effe
cts
for:
opio
ids,
anx
ioly
tics,
ant
iem
etic
s,
laxa
tives
, psy
chos
timul
ants
, cor
ticos
tero
ids,
an
tidep
ress
ants
, ant
ihis
tam
ines
, neu
role
ptic
s,
seda
tives
and
oth
er c
omm
on a
gent
s us
ed in
pa
lliativ
e ca
re p
ract
ice
Pre
scrib
es a
sat
isfa
ctor
y bo
wel
re
gim
en w
hene
ver p
resc
ribin
g op
ioid
s
Pre
scrib
es b
enzo
diaz
epin
es w
ith a
n aw
aren
ess
of th
eir h
alf-
lives
, ap
prop
riate
titra
tion,
and
com
mon
to
xici
ties
App
ropr
iate
ly s
ugge
sts
neur
olep
tics
for d
eliri
um a
nd a
gita
tion,
and
is
able
to p
rovi
de a
ratio
nale
for u
se o
f pa
rticu
lar a
gent
s
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
2.10
Des
crib
es th
e us
e of
non
-ph
arm
acol
ogic
app
roac
hes
to th
e m
anag
emen
t of p
ain
and
non-
pain
sy
mpt
oms
2.10
.1 I
dent
ifies
indi
catio
ns, t
oxic
ities
, and
ap
prop
riate
refe
rral f
or in
terv
entio
nal p
ain
man
agem
ent p
roce
dure
s, a
s w
ell a
s su
rgic
al
proc
edur
es c
omm
only
use
d fo
r pai
n an
d no
n-pa
in s
ympt
om m
anag
emen
t
In d
escr
ibin
g th
e di
agno
sis
and
treat
men
t of p
ancr
eatic
can
cer,
expl
ains
the
role
of c
elia
c pl
exus
bl
ock,
com
plic
atio
ns, a
nd u
sual
ou
tcom
es
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
2.10
.2 I
dent
ifies
indi
catio
ns, t
oxic
ities
, m
anag
emen
t of c
omm
on s
ide
effe
cts,
and
ap
prop
riate
refe
rral f
or ra
diat
ion
ther
apy
Sug
gest
s th
e us
e of
hyp
o-fra
ctio
nate
d ra
diat
ion
ther
apy
for
sele
cted
pat
ient
s w
ith m
etas
tatic
bo
ne c
ance
r
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 26
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
2.10
.3 I
dent
ifies
indi
catio
ns, t
oxic
ities
, and
ap
prop
riate
refe
rral f
or c
omm
only
use
d co
mpl
emen
tary
and
alte
rnat
ive
ther
apie
s, i.
e.
acup
unct
ure,
aro
mat
hera
py, g
uide
d im
ager
y
For a
ppro
pria
tely
sel
ecte
d pa
tient
s,
expl
ains
and
sug
gest
s re
laxa
tion
exer
cise
s, a
nd m
akes
app
ropr
iate
re
ferr
als
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
2.10
.4 E
xpla
ins
the
role
of a
llied
heal
th
prof
essi
ons
in p
ain
and
non-
pain
sym
ptom
m
anag
emen
t, su
ch a
s sp
eech
, phy
sica
l, re
spira
tory
, and
occ
upat
iona
l the
rapy
For p
atie
nts
with
ALS
at v
ario
us
stag
es o
f pro
gres
sion
, is
fam
iliar
with
and
abl
e to
pre
scrib
e ap
prop
riate
use
of s
peec
h, p
hysi
cal,
resp
irato
ry, a
nd o
ccup
atio
nal
ther
apy
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E SP
2.11
Des
crib
es th
e et
iolo
gy,
path
ophy
siol
ogy,
dia
gnos
is, a
nd
man
agem
ent o
f com
mon
neu
rops
ychi
atric
di
sord
ers
enco
unte
red
in p
allia
tive
care
pr
actic
e, s
uch
as d
epre
ssio
n, d
eliri
um,
seiz
ures
, and
bra
in in
jury
2.11
.1 R
ecog
nize
s ho
w to
eva
luat
e, a
nd tr
eat
com
mon
neu
rops
ychi
atric
dis
orde
rs
Des
crib
es a
n or
gani
zed,
ste
p-w
ise
appr
oach
to e
valu
atio
n an
d tre
atm
ent o
f com
mon
ne
urop
sych
iatri
c di
sord
ers
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
2.11
.2 D
escr
ibes
how
to re
fer a
ppro
pria
tely
to
neur
olog
ical
and
men
tal h
ealth
pro
fess
iona
ls
Iden
tifie
s tri
gger
s fo
r ref
erra
l to
a ne
urol
ogis
t or m
enta
l hea
lth
prof
essi
onal
MC
E A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wS
tand
ardi
zed
oral
exa
min
atio
n 2.
11.3
Des
crib
es th
e in
dica
tions
, co
ntra
indi
catio
ns, p
harm
acol
ogy,
app
ropr
iate
pr
escr
ibin
g pr
actic
e, a
nd s
ide-
effe
cts
of
com
mon
psy
chia
tric
med
icat
ions
Dis
cuss
es th
e m
ain
indi
catio
ns a
nd
cont
rain
dica
tions
, bas
ic
phar
mac
olog
y, a
ppro
pria
te
pres
crib
ing
prac
tice,
and
mai
n si
de
effe
cts
of S
SR
Is, t
ricyc
lic
antid
epre
ssan
ts, a
ntic
onvu
lsan
ts,
benz
odia
zepe
nes,
ant
ipsy
chot
ics,
MC
E A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wS
tand
ardi
zed
oral
exa
min
atio
n
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 27
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
barb
itura
tes
2.11
.4 R
ecog
nize
s th
e di
agno
stic
crit
eria
and
m
anag
emen
t iss
ues
of b
rain
dea
th, p
ersi
sten
t ve
geta
tive
stat
e, a
nd m
inim
ally
con
scio
us s
tate
List
s th
e di
agno
stic
crit
eria
for b
rain
de
ath
and
pers
iste
nt v
eget
ativ
e st
ate,
Des
crib
es c
omm
on m
anag
emen
t is
sues
aro
und
brai
n de
ath
and
pe
rsis
tent
veg
etat
ive
stat
e
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n M
ini-C
EX
2.12
Rec
ogni
zes
com
mon
psy
chol
ogic
al
stre
ssor
s an
d di
sord
ers
expe
rienc
ed b
y pa
tient
s an
d fa
milie
s fa
cing
life
-thre
aten
ing
cond
ition
s, a
nd d
escr
ibes
app
ropr
iate
cl
inic
al a
sses
smen
t and
man
agem
ent.
2.12
.1 R
ecog
nize
s ps
ycho
logi
cal d
istre
ssId
entif
ies
the
pres
ence
of c
omm
on
psyc
holo
gica
l stre
ssor
s
Ass
esse
s fo
r com
mon
phy
sica
l and
be
havi
oral
sig
ns o
f psy
chol
ogic
al
dist
ress
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n O
SC
E/S
PM
ini-C
EX
360
Eva
luat
ion
2.12
.2 D
escr
ibes
con
cept
s of
cop
ing
styl
es,
psyc
holo
gica
l def
ense
s, a
nd d
evel
opm
enta
l st
ages
rele
vant
to th
e ev
alua
tion
and
man
agem
ent o
f psy
chol
ogic
al d
istre
ss
List
s an
d de
fines
cop
ing
styl
es a
nd
psyc
holo
gica
l def
ense
s
Iden
tifie
s re
leva
nt c
opin
g st
yles
and
ps
ycho
logi
cal d
efen
se m
echa
nism
s
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
Sta
ndar
dize
d or
al e
xam
inat
ion
Min
i-CE
XO
SC
E/S
P2.
12.3
Des
crib
es h
ow to
pro
vide
bas
ic
supp
ortiv
e co
unse
ling
and
to s
treng
then
cop
ing
skills
List
s ba
sic
conc
epts
of s
uppo
rtive
co
unse
ling
and
stra
tegi
es to
st
reng
then
cop
ing
skills
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 2.
12.4
Rec
ogni
zes
the
need
s of
min
or c
hild
ren
whe
n an
adu
lt pa
rent
or c
lose
rela
tive
is
serio
usly
ill o
r dyi
ng, a
nd p
rovi
des
appr
opria
te
Rou
tinel
y ev
alua
tes
issu
es a
nd
need
s of
min
or c
hild
ren
invo
lved
in
case
s
360
Eva
luat
ion
OS
CE
/SP
Min
i-CE
X
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 28
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
basi
c co
unse
ling
or re
ferr
al
Dem
onst
rate
s ef
fect
ive
basi
c co
unse
ling
and
appr
opria
te re
ferr
al
for m
inor
chi
ldre
n
360
Eva
luat
ion
OS
CE
/SP
Min
i-CE
X2.
12.5
Rec
ogni
zes
the
need
s of
par
ents
and
si
blin
gs o
f chi
ldre
n w
ho a
re s
erio
usly
ill o
r dyi
ng
and
pro
vide
s ap
prop
riate
bas
ic c
ouns
elin
g or
re
ferr
al
Rou
tinel
y ev
alua
tes
need
s of
si
blin
gs a
nd p
aren
ts w
hen
child
ren
are
serio
usly
ill
Dem
onst
rate
s ef
fect
ive
basi
c co
unse
ling
and
appr
opria
te re
ferr
al
for s
iblin
gs a
nd p
aren
ts
360
Eva
luat
ion
OS
CE
/SP
Min
i-CE
X
360
Eva
luat
ion
OS
CE
/SP
Min
i-CE
XM
ay d
elet
e or
com
bine
with
2.1
1.2
late
r on
2.12
.6 E
xpla
ins
appr
opria
te u
tiliz
atio
n of
co
nsul
tatio
n w
ith s
peci
alis
ts in
psy
chos
ocia
l as
sess
men
t and
man
agem
ent
Iden
tifie
s co
mm
on tr
igge
rs fo
r sp
ecia
list c
onsu
ltatio
n in
the
psyc
hoso
cial
dom
ain
MC
E S
tand
ardi
zed
oral
exa
min
atio
n M
ini-C
EX
2.13
Rec
ogni
zes
com
mon
soc
ial p
robl
ems
expe
rienc
ed b
y pa
tient
s an
d fa
milie
s fa
cing
lif
e-th
reat
enin
g co
nditi
ons
and
desc
ribes
ap
prop
riate
clin
ical
ass
essm
ent a
nd
man
agem
ent
2.13
.1 A
ble
to a
sses
s, c
ouns
el, s
uppo
rt, a
nd
mak
e ap
prop
riate
refe
rrals
to a
llevi
ate
the
burd
en o
f car
egiv
ing
Iden
tifie
s si
gns
of c
areg
iver
bur
den
Exp
lain
s s
trate
gies
to re
lieve
ca
regi
ver b
urde
n
Rou
tinel
y as
sess
es fo
r lev
el o
f ca
regi
ver b
urde
n
Ref
ers
appr
opria
tely
to c
olle
ague
s to
ad
dres
s ca
regi
ver b
urde
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n M
ini-C
EX
OS
CE
/SP
360
Eva
luat
ion
Min
i-CE
X
360
Eva
luat
ion
Pee
ras
sess
men
t of
fello
w2.
13.2
Abl
e to
ass
ess,
pro
vide
sup
port,
and
m
ake
appr
opria
te re
ferra
l aro
und
fisca
l iss
ues,
in
sura
nce
cove
rage
, and
lega
l con
cern
s
Rou
tinel
y as
sess
es fo
r dis
tress
ar
ound
fina
ncia
l ins
uran
ce, a
nd le
gal
conc
erns
Ref
ers
appr
opria
tely
to c
olle
ague
s to
ad
dres
s fin
anci
al,
insu
ranc
e an
d le
gal c
once
rns
360
Eva
luat
ion
Min
i-CE
X
360
Eva
luat
ion
Pee
ras
sess
men
t of
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 29
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
fello
w2.
14 R
ecog
nize
s co
mm
on e
xper
ienc
es o
f di
stre
ss a
roun
d sp
iritu
al, r
elig
ious
, and
ex
iste
ntia
l iss
ues
for p
atie
nts
and
fam
ilies
faci
ng li
fe-th
reat
enin
g co
nditi
ons,
and
de
scrib
es e
lem
ents
of a
ppro
pria
te c
linic
al
asse
ssm
ent a
nd m
anag
emen
t
2.14
.1 D
escr
ibes
the
role
of h
ope,
des
pair,
m
eani
ng, a
nd tr
ansc
ende
nce
in th
e co
ntex
t of
seve
re a
nd c
hron
ic il
lnes
s
Def
ines
hop
e, d
espa
ir, m
eani
ng a
nd
trans
cend
ence
in a
pra
ctic
al s
ense
th
at p
rom
otes
und
erst
andi
ng fo
r pa
tient
s, fa
milie
s, a
nd s
taff
in th
is
setti
ng
360
Eva
luat
ion
Pee
ras
sess
men
t of
fello
wA
ttend
ing
phys
icia
n as
sess
men
t of
fello
wS
tand
ardi
zed
oral
exa
min
atio
n 2.
14.2
Des
crib
es h
ow to
per
form
a b
asic
sp
iritu
al/e
xist
entia
l/rel
igio
us e
valu
atio
n E
xpla
ins
an o
rgan
ized
app
roac
h to
co
verin
g ba
sic
elem
ents
of a
sp
iritu
al/e
xist
entia
l/rel
igio
us h
isto
ry
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E 2.
14.3
Des
crib
es h
ow to
pro
vide
bas
ic s
pirit
ual
coun
selin
g
Def
ines
bas
ic p
rinci
ples
of s
pirit
ual
coun
selin
g an
d co
mm
on s
cena
rios
whe
re c
ouns
elin
g co
uld
be o
f ben
efit
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 2.
14.4
Ide
ntifi
es th
e in
dica
tions
for r
efer
ral t
o ch
apla
incy
or o
ther
spi
ritua
l cou
nsel
ors
and
reso
urce
s
List
s in
dica
tions
for r
efer
ral t
o ch
apla
incy
or o
ther
spi
ritua
l re
sour
ces
MC
ES
tand
ardi
zed
oral
exa
min
atio
n 2.
14.5
Kno
ws
the
deve
lopm
enta
l pro
cess
es,
task
s, a
nd v
aria
tions
of l
ife c
ompl
etio
n an
d lif
e cl
osur
e
Des
crib
es c
omm
on ta
sks
of li
fe
clos
ure
for d
ying
pat
ient
s
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 2.
14.6
Des
crib
es p
roce
sses
for f
acilit
atin
g gr
owth
and
dev
elop
men
t in
the
cont
ext o
f ad
vanc
ed il
lnes
s
Nam
es s
trate
gies
to fa
cilit
ate
grow
th
and
deve
lopm
ent f
or a
pat
ient
with
ad
vanc
ed il
lnes
s
MC
E S
tand
ardi
zed
oral
exa
min
atio
n M
ini-C
EX
OS
CE
/SP
2.15
Abl
e to
reco
gniz
e, e
valu
ate,
and
su
ppor
t div
erse
cul
tura
l val
ues
and
cust
oms
with
rega
rd to
info
rmat
ion
shar
ing,
dec
isio
n m
akin
g, e
xpre
ssio
n an
d tre
atm
ent o
f ph
ysic
al a
nd e
mot
iona
l dis
tress
, and
pr
efer
ence
s fo
r site
s of
car
e an
d de
ath.
2.15
.1 R
ecog
nize
s m
ajor
con
tribu
tions
from
no
n-m
edic
al d
isci
plin
es, s
uch
as s
ocio
logy
, an
thro
polo
gy, a
nd h
ealth
psy
chol
ogy,
in
unde
rsta
ndin
g an
d m
anag
ing
the
patie
nt’s
and
fa
mily
’s e
xper
ienc
e of
ser
ious
and
life
-th
reat
enin
g illn
ess
Ass
esse
s pa
tient
and
fam
ily c
ultu
ral
valu
es a
nd c
usto
ms
in re
gard
to
info
rmat
ion
shar
ing,
dec
isio
n-m
akin
g, e
xpre
ssio
n an
d tre
atm
ent o
f ph
ysic
al a
nd e
mot
iona
l dis
tress
, and
pr
efer
ence
s fo
r site
s of
car
e an
d de
ath
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E P
eer
asse
ssm
ent o
f fe
llow
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 30
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
Dem
onst
rate
s re
spec
t for
and
effo
rt to
hon
or d
iver
se c
ultu
ral v
alue
s an
d cu
stom
s
Cha
rt/re
cord
re
view
36
0 de
gree
2.
16 R
ecog
nize
s th
e co
mpo
nent
s of
m
anag
emen
t for
the
synd
rom
e of
imm
inen
t de
ath
2.16
.1 I
dent
ifies
com
mon
sym
ptom
s, s
igns
, co
mpl
icat
ions
and
var
iatio
ns in
the
norm
al d
ying
pr
oces
s an
d th
eir m
anag
emen
t
Des
crib
es s
tage
s of
dyi
ng, i
nclu
ding
co
mm
on s
ympt
oms,
sig
ns, a
nd
com
plic
atio
ns, a
s w
ell a
s re
leva
nt
man
agem
ent s
trate
gies
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E
2.16
.2 D
escr
ibes
stra
tegi
es to
com
mun
icat
e w
ith p
atie
nt a
nd fa
mily
abo
ut th
e dy
ing
proc
ess
and
to p
rovi
de s
uppo
rt
Iden
tifie
s ap
proa
ches
for
com
mun
icat
ing
with
a p
atie
nt a
nd
fam
ily a
bout
the
dyin
g pr
oces
s
Des
crib
es s
trate
gies
for
dem
onst
ratin
g su
ppor
t to
a pa
tient
an
d fa
mily
dur
ing
the
dyin
g pr
oces
s
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E M
ini-C
EX
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E M
ini-C
EX
2.17
Rec
ogni
zes
the
elem
ents
of
appr
opria
te c
are
of th
e pa
tient
and
fam
ily a
t th
e tim
e of
dea
th a
nd im
med
iate
ly th
erea
fter
2.17
.1 D
escr
ibes
app
ropr
iate
and
sen
sitiv
e pr
onou
ncem
ent o
f dea
th
Exp
lain
s a
step
-wis
e pr
oces
s fo
r de
ath
pron
ounc
emen
t, in
clud
ing
pers
onal
pre
para
tion,
pat
ient
as
sess
men
t, fa
mily
not
ifica
tion,
and
do
cum
enta
tion
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E M
ini-C
EX
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E M
ini-C
EX
2.17
.2 I
dent
ifies
the
stan
dard
pro
cedu
ral
com
pone
nts
and
psyc
hoso
cial
ele
men
ts o
f pos
t-de
ath
care
Des
crib
es p
ost-d
eath
car
e, in
clud
ing
fam
ily n
otifi
catio
n of
dea
th, a
utop
sy
optio
n, o
rgan
don
atio
n op
tion,
fu
nera
l arr
ange
men
ts, r
outin
e ca
re
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E A
ttend
ing
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 31
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
of th
e bo
dy, a
nd d
eath
cer
tific
ate
com
plet
ion
ph
ysic
ian
asse
ssm
ent o
f fe
llow
2.17
.3 R
ecog
nize
s th
e po
tent
ial i
mpo
rtanc
e an
d ex
iste
nce
of p
ost-d
eath
ritu
als
and
how
to
faci
litat
e th
em
Rou
tinel
y el
icits
and
faci
litat
es p
ost-
deat
h rit
uals
of i
mpo
rtanc
e to
pa
tient
s an
d fa
milie
s
360
Eva
luat
ion
Pee
ras
sess
men
t of
fello
wC
hart/
reco
rd
revi
ew
2.18
Des
crib
es th
e ba
sic
scie
nce,
ep
idem
iolo
gy, c
linic
al fe
atur
es, n
atur
al
cour
se, s
tage
s, a
nd m
anag
emen
t opt
ions
for
norm
al a
nd p
atho
logi
c gr
ief
2.18
.1 D
emon
stra
tes
know
ledg
e of
nor
mal
grie
f an
d el
emen
ts o
f ber
eave
men
t fol
low
-up,
in
clud
ing
asse
ssm
ent,
treat
men
t, an
d re
ferra
l op
tions
for b
erea
ved
fam
ily m
embe
rs
Def
ines
nor
mal
grie
f
List
s el
emen
ts o
f ber
eave
men
t as
sess
men
t
Iden
tify
appr
oach
es to
ber
eave
men
t tre
atm
ent
Exp
lain
loca
l ref
erra
l opt
ions
for
bere
avem
ent c
ouns
elin
g
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 2.
18.2
Rec
ogni
zes
the
risk
fact
ors,
dia
gnos
tic
feat
ures
, epi
dem
iolo
gy, a
nd m
anag
emen
t of
depr
essi
on a
nd c
ompl
icat
ed g
rief
Dis
cuss
risk
fact
ors,
dia
gnos
tic
feat
ures
, and
epi
dem
iolo
gy o
f co
mpl
icat
ed g
rief a
nd d
epre
ssio
n as
soci
ated
with
ber
eave
men
t
Iden
tify
man
agem
ent s
trate
gies
for
com
plic
ated
grie
f and
dep
ress
ion
asso
ciat
ed w
ith b
erea
vem
ent
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 2.
18.3
. A
ppre
ciat
es ri
sk o
f sui
cide
in th
e be
reav
ed a
nd c
arrie
s ou
t ini
tial a
sses
smen
t for
A
ttend
ing
phys
icia
n
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 32
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
suic
ide
risk
asse
ssm
ent o
f fe
llow
MC
E 2.
19 D
escr
ibes
com
mon
issu
es in
the
palli
ativ
e ca
re m
anag
emen
t of p
edia
tric
and
geria
tric
patie
nts
and
thei
r fam
ilies
that
diff
er
from
car
ing
for a
dult
patie
nts,
in re
gard
to
phys
iolo
gy, v
ulne
rabi
litie
s, a
nd
deve
lopm
enta
l sta
ges
2.19
.1 D
escr
ibes
the
epid
emio
logy
of p
edia
tric
life-
thre
aten
ing
cond
ition
s N
ames
com
mon
cau
ses
of d
eath
for
infa
nts,
chi
ldre
n, a
nd a
dole
scen
ts
and
the
age
rang
es fo
r the
se
cate
gorie
s
Dis
cuss
es th
e di
fficu
lty o
f pr
ogno
stic
atio
n in
the
setti
ng o
f rar
e sy
ndro
mes
and
oth
er c
onge
nita
l ab
norm
aliti
es in
chi
ldho
od a
nd it
s re
leva
nce
to c
linic
al c
are
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
Sta
ndar
dize
d or
al e
xam
inat
ion
2.19
.2 A
ppre
ciat
es d
evel
opm
enta
l per
spec
tives
on
illn
ess,
grie
f, an
d lo
ss
Exp
lain
s co
mm
on a
ge- s
peci
fic
pers
pect
ives
for p
atie
nts
and
fam
ily
mem
bers
, as
appl
ied
to i
llnes
s,
loss
, and
grie
f
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 36
0 E
valu
atio
n M
ini-C
EX
2.19
.3 D
escr
ibes
pha
rmac
olog
ic p
rinci
ples
ap
plic
able
to th
e m
anag
emen
t of s
ympt
oms
in
infa
nts,
chi
ldre
n, a
nd a
dole
scen
ts
Exp
lain
s w
eigh
t-bas
ed d
osin
g ap
proa
ch fo
r med
icat
ions
in
pedi
atric
pat
ient
s.
Rec
ogni
zes
the
emph
asis
on
prev
entin
g an
d m
anag
ing
proc
edur
e-re
late
d pa
in in
ped
iatri
cs
Nam
es p
hysi
olog
ic c
hara
cter
istic
s of
ne
onat
es th
at m
ay a
ffect
opi
oid
phar
mac
olog
y
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n
MC
E S
tand
ardi
zed
oral
exa
min
atio
n 2.
20 D
escr
ibes
eth
ical
and
lega
l iss
ues
in
pallia
tive
and
end-
of-li
fe c
are
and
thei
r cl
inic
al m
anag
emen
t
2.20
.1 D
iscu
sses
eth
ical
prin
cipl
es a
nd
fram
ewor
ks fo
r add
ress
ing
clin
ical
issu
es
Exp
lain
s co
mm
on e
thic
al p
rinci
ples
an
d th
eir a
pplic
atio
n in
pal
liativ
e m
edic
ine
App
lies
ethi
cal p
rinci
ples
to g
iven
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 33
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
ethi
cal d
ilem
ma
S
tand
ardi
zed
oral
exa
min
atio
n M
ini-C
EX
OS
CE
/SP
Writ
ing
assi
gnm
ent
2.20
.2 D
escr
ibes
fede
ral,
stat
e, a
nd lo
cal l
aws
and
prac
tices
that
impa
ct o
n pa
lliativ
e ca
re
prac
tice
Dis
cuss
es fe
dera
l, st
ate,
and
loca
l la
ws
rega
rdin
g su
ch is
sues
as
adva
nce
dire
ctiv
es, c
ontro
lled
subs
tanc
e re
gula
tion,
man
agem
ent
of re
susc
itatio
n st
atus
, lim
its o
f do
ctor
-pat
ient
rela
tions
hip,
dec
isio
n-m
akin
g ca
paci
ty a
nd c
onse
nt, a
nd
man
agem
ent o
f life
-sus
tain
ing
ther
apy
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E M
ini-C
EX
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
2.20
.3 C
onsu
lts c
linic
al e
thic
ist a
ppro
pria
tely
Exp
lain
s lo
cal p
roce
dure
for e
thic
s co
nsul
tatio
n
Iden
tifie
s ap
prop
riate
sce
nario
s fo
r et
hics
invo
lvem
ent
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
MC
E S
tand
ardi
zed
oral
exa
min
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wM
ini-C
EX
2.20
.4 D
escr
ibes
pro
fess
iona
l and
inst
itutio
nal
ethi
cal p
olic
ies
rele
vant
to p
allia
tive
care
pr
actic
e
Exp
lain
s pr
ofes
sion
al a
nd
inst
itutio
nal e
thic
al p
olic
ies
com
mon
ly a
pplie
d to
pal
liativ
e ca
re
prac
tice,
suc
h as
lim
iting
life
-su
stai
ning
ther
apie
s, u
se o
f adv
ance
di
rect
ives
, dec
isio
n-m
akin
g ca
paci
ty
Sta
ndar
dize
d or
al e
xam
inat
ion
MC
E M
ini-C
EX
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 34
Med
ical
Kno
wle
dge
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
360
Eva
luat
ion
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 35
Prac
tice-
Bas
ed L
earn
ing
and
Impr
ovem
ent
Com
pete
ncy
Su
b-co
mpe
tenc
y Sa
mpl
e B
ehav
ior
Ass
essm
ent
Met
hod
3.1
Mai
ntai
ns s
afe
and
com
pete
nt
prac
tice,
incl
udin
g se
lf-ev
alua
tion
and
cont
inuo
us le
arni
ng
3.1.
1 D
emon
stra
tes
an a
bilit
y to
sel
f-ref
lect
on
pers
onal
lear
ning
def
icie
ncie
s an
d de
velo
p a
plan
for i
mpr
ovem
ent
Sel
f ass
ess
and
criti
que
pers
onal
le
arni
ng d
efic
ienc
ies.
C
hoos
e a
plan
of r
emed
iatio
n.
360
Eva
luat
ion
Por
tfolio
3.1.
2 D
emon
stra
tes
know
ledg
e of
and
co
mm
itmen
t to
cont
inui
ng p
rofe
ssio
nal
deve
lopm
ent a
nd li
fe-lo
ng le
arni
ng
Con
stru
ct a
pla
n fo
r life
-long
lear
ning
–
stay
ing
up to
dat
e, o
btai
ning
CM
E,
goal
orie
nted
pro
fess
iona
l de
velo
pmen
t. P
artic
ipat
es in
pro
gram
and
in
stitu
tiona
l con
tinui
ng m
edic
al
educ
atio
n of
ferin
gs
360
Eva
luat
ion
Por
tfolio
3.1.
3 D
emon
stra
tes
know
ledg
e of
the
role
s an
d re
spon
sibi
litie
s of
the
train
ee/m
ento
r A
pplie
s kn
owle
dge
of tr
aine
e/m
ento
r ro
le in
dai
ly a
ctiv
ities
– lo
oks
to
men
tor f
or a
ppro
pria
te g
uida
nce,
fo
llow
s th
roug
h on
agr
eed
task
s,
open
to a
ssum
ing
men
tor r
ole
in
inte
ract
ions
with
trai
nees
Glo
bal r
atin
g sc
ale
Por
tfolio
Act
ivity
log
3.1.
4 D
emon
stra
tes
the
abilit
y to
refle
ct o
n hi
s/he
r per
sona
l lea
rnin
g st
yle
and
use
diffe
rent
opp
ortu
nitie
s fo
r lea
rnin
g
Cat
egor
ize
pers
onal
lear
ning
sty
les
in
deve
lopm
ent o
f sel
f-lea
rnin
g pl
an
Cha
rt/re
cord
re
view
P
ortfo
lio
3.1.
5 D
emon
stra
tes
the
abilit
y to
act
ivel
y se
ek
and
utiliz
e fe
edba
ck
Inte
rpre
t fee
dbac
k to
impr
ove
patie
nt
care
and
col
legi
al re
latio
nshi
ps
Rou
tinel
y se
eks
feed
back
D
iscu
sses
cur
rent
are
as fo
r per
sona
l im
prov
emen
t.
Che
cklis
tev
alua
tion
3.1.
6 D
emon
stra
tes
the
abilit
y to
dev
elop
an
effe
ctiv
e le
arni
ng re
latio
nshi
p w
ith m
embe
rs o
f th
e fa
culty
and
oth
er p
rofe
ssio
nals
Com
bine
feed
back
and
Fel
low
sel
f-as
sess
men
t int
o a
plan
for e
ffect
ivel
y w
orki
ng w
ith c
olle
ague
s an
d pe
ers
360
Eva
luat
ion
Che
cklis
tev
alua
tion
3.2
Acc
esse
s, a
naly
zes
and
appl
ies
the
evid
ence
bas
e to
clin
ical
pra
ctic
e in
pa
lliativ
e ca
re
3.2.
1 D
emon
stra
tes
know
ledg
e of
, and
re
cogn
izes
lim
itatio
ns o
f, ev
iden
ce-b
ased
m
edic
ine
in p
allia
tive
care
Diff
eren
tiate
s th
e qu
ality
of r
esea
rch
in p
allia
tive
care
for p
atie
nt c
are
appl
icat
ions
. A
ble
to a
naly
ze th
e ev
iden
ce-b
ase
for a
par
ticul
ar c
linic
al q
uest
ion
with
di
scus
sion
of l
imita
tions
Cha
rt/re
cord
re
view
M
CE
Sta
ndar
dize
d or
al e
xam
C
heck
list
eval
uatio
n
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 36
Prac
tice-
Bas
ed L
earn
ing
and
Impr
ovem
ent
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
3.2.
2 A
ctiv
ely
seek
s to
app
ly th
e be
st
avai
labl
e ev
iden
ce to
pat
ient
car
e to
faci
litat
e sa
fe, u
p-to
-dat
e cl
inic
al p
ract
ice,
and
en
cour
ages
oth
ers
to d
o so
Use
s be
st m
edic
al re
sear
ch to
sol
ve
patie
nt-c
are
prob
lem
s.
Faci
litat
es e
nviro
nmen
t of a
pplic
atio
n of
bes
t evi
denc
e as
mem
ber o
f cl
inic
al te
am
Cha
rt/re
cord
re
view
M
CE
Sta
ndar
dize
d or
al e
xam
C
heck
list
eval
uatio
n P
eer
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
3.3
Dev
elop
s co
mpe
tenc
ies
as a
n ed
ucat
or
3.3.
1 R
ecog
nize
s th
e im
porta
nce
of
asse
ssin
g le
arni
ng n
eeds
in in
itiat
ing
a te
achi
ng e
ncou
nter
Em
ploy
s a
need
s as
sess
men
t pr
oces
s in
edu
catio
nal p
lann
ing.
P
ortfo
lio
3.3.
2 D
escr
ibes
the
impo
rtanc
e of
def
inin
g le
arni
ng g
oals
and
obj
ectiv
es a
s a
basi
s fo
r de
velo
ping
edu
catio
nal s
essi
ons
Exp
lain
s w
hy d
evel
opin
g le
arni
ng
obje
ctiv
es a
re e
ssen
tial i
n ed
ucat
iona
l pro
gram
dev
elop
men
t.
Des
crib
es k
ey c
ompo
nent
s fo
r writ
ing
an e
ffect
ive
lear
ning
obj
ectiv
e
Por
tfolio
3.3.
3 R
efle
cts
on b
enef
its a
nd d
raw
back
s of
al
tern
ativ
e ap
proa
ches
to te
achi
ng, a
nd th
e ro
le o
f diff
eren
t tea
chin
g te
chni
ques
to
addr
ess
know
ledg
e, a
ttitu
des,
and
ski
lls
App
rais
es a
udie
nce
lear
ning
nee
ds
and
lear
ning
obj
ectiv
es in
the
choi
ce
of te
achi
ng te
chni
ques
.
Iden
tifie
s ra
nge
of p
oten
tial t
each
ing
stra
tegi
es a
nd e
xpla
ins
thei
r ap
plic
atio
n to
teac
hing
kno
wle
dge,
sk
ills a
nd a
ttitu
des
Dis
cuss
es b
enef
its a
nd d
raw
back
s of
pa
rticu
lar t
each
ing
stra
tegi
es in
a
give
n ci
rcum
stan
ce
Par
ticip
ates
in te
achi
ng c
ontin
uing
m
edic
al e
duca
tion
offe
rings
to o
ther
di
scip
lines
Por
tfolio
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 37
Prac
tice-
Bas
ed L
earn
ing
and
Impr
ovem
ent
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
3.3.
4 D
emon
stra
tes
the
abilit
y to
sup
ervi
se
clin
ical
trai
nees
(e.g
., m
edic
al s
tude
nts,
re
side
nts,
and
oth
er h
ealth
car
e pr
ofes
sion
als)
an
d gi
ve c
onst
ruct
ive
feed
back
Eva
luat
es c
linic
al tr
aine
es u
sing
ob
ject
ive
met
rics.
Crit
ique
s cl
inic
al tr
aine
es in
a
prof
essi
onal
man
ner a
ckno
wle
dgin
g po
sitiv
es a
nd a
reas
for i
mpr
ovem
ent.
Lear
ner
asse
ssm
ent o
f fe
llow
Che
cklis
tev
alua
tion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w
3.3.
5 S
how
s re
spec
t tow
ards
lear
ners
D
emon
stra
tes
resp
ect a
nd e
mpa
thy
for l
earn
ers
360
Eva
luat
ion
Lear
ner
asse
ssm
ent o
f fe
llow
3.4
Dem
onst
rate
s kn
owle
dge
of th
e pr
oces
s an
d op
portu
nitie
s fo
r res
earc
h in
pa
lliativ
e ca
re
3.4.
1 R
ecog
nize
s an
d va
lues
the
impo
rtanc
e of
add
ress
ing
ethi
cal i
ssue
s in
pal
liativ
e ca
re
rese
arch
Exp
lain
s ke
y et
hica
l iss
ues
in
pallia
tive
care
rese
arch
. P
ortfo
lio
3.4.
2 Is
real
istic
abo
ut th
e be
nefit
s an
d ch
alle
nges
of p
allia
tive
care
rese
arch
and
su
ppor
ts re
sear
ch a
s ap
prop
riate
to th
e se
tting
Rec
ogni
zes
the
valu
e of
pal
liativ
e ca
re re
sear
ch.
Por
tfolio
3.4.
3 R
ecog
nize
s an
d va
lues
the
use
of d
ata
to d
emon
stra
te c
linic
al, u
tiliz
atio
n, a
nd
finan
cial
out
com
es o
f pal
liativ
e ca
re
Des
crib
es h
ow p
allia
tive
care
fin
anci
al d
ata
can
be u
sed
to p
lan
for
diffe
rent
clin
ical
ser
vice
del
iver
y m
odel
s.
Por
tfolio
MC
E S
tand
ardi
zed
oral
exa
m
3.5
Des
crib
es c
omm
on a
ppro
ache
s to
qu
ality
and
saf
ety
assu
ranc
e 3.
5.1
Dem
onst
rate
s an
ope
nnes
s an
d w
illing
ness
to e
valu
ate
and
parti
cipa
te in
pr
actic
e an
d se
rvic
e im
prov
emen
t
Use
s cl
inic
al d
ata
to d
evel
op c
linic
al
prac
tice
impr
ovem
ent p
roje
cts
in
pallia
tive
care
.
Des
crib
es a
mod
el fo
r app
roac
hing
he
alth
care
impr
ovem
ent a
nd c
an
appl
y to
clin
ical
pro
blem
, i.e
. PD
SA
C
ycle
or M
odel
for I
mpr
ovem
ent
Por
tfolio
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 38
Prac
tice-
Bas
ed L
earn
ing
and
Impr
ovem
ent
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
3.5.
2 D
emon
stra
tes
know
ledg
e of
pal
liativ
e ca
re’s
clin
ical
, fin
anci
al, a
nd q
ualit
y-of
-car
e ou
tcom
e m
easu
res
Iden
tifie
s ke
y cl
inic
al, f
inan
cial
and
qu
ality
of l
ife m
easu
rem
ent t
ools
. P
ortfo
lioM
CE
Sta
ndar
dize
d or
al e
xam
3.
5.3
Dem
onst
rate
s aw
aren
ess
of a
nd
adhe
renc
e to
pat
ient
saf
ety
stan
dard
s U
ses
patie
nt s
afet
y st
anda
rds
in d
aily
cl
inic
al p
ract
ice.
Iden
tifie
s po
tent
ial p
atie
nt s
afet
y is
sues
in a
ny g
iven
clin
ical
sce
nario
Che
cklis
tev
alua
tion
360
Eva
luat
ion
Por
tfolio
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 39
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Sam
ple
Beh
avio
r A
sses
smen
t M
etho
d 4.
1 In
itiat
es in
form
ed re
latio
nshi
p-ce
nter
ed d
ialo
gues
abo
ut c
are
4.1.
1 A
sses
ses
patie
nt/fa
mily
wis
hes
rega
rdin
g th
e am
ount
of i
nfor
mat
ion
they
wis
h to
rece
ive
and
the
exte
nt o
f the
ir pa
rtici
patio
n in
clin
ical
dec
isio
n-m
akin
g
Inqu
ires
abou
t how
muc
h in
form
atio
n th
e pe
rson
wan
ts a
t the
initi
al v
isit
Ask
s if
the
patie
nt w
ants
to b
e in
volv
ed in
dec
isio
n m
akin
g w
hen
disc
ussi
ng g
oals
of c
are
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
1.2
Det
erm
ines
, in
colla
bora
tion
with
pa
tient
/fam
ily, t
he a
ppro
pria
te p
artic
ipan
ts in
di
scus
sion
s co
ncer
ning
a p
atie
nt’s
car
e
Inqu
ires
if th
ere
are
othe
r peo
ple
who
sh
ould
be
pres
ent w
hen
givi
ng b
ad
new
s
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
1.3
Ass
esse
s pa
tient
’s a
nd fa
mily
m
embe
rs’ d
ecis
ion-
mak
ing
capa
city
, and
ot
her s
treng
ths
and
limita
tions
of
unde
rsta
ndin
g an
d co
mm
unic
atio
n
Can
just
ify a
det
erm
inat
ion
of
deci
sion
mak
ing
capa
city
Can
dis
cuss
diff
eren
t crit
eria
and
th
eir a
dvan
tage
s an
d di
sadv
anta
ges
for d
eter
min
ing
deci
sion
mak
ing
capa
city
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
1.4
Enl
ists
lega
l sur
roga
tes
to s
peak
on
beha
lf of
a p
atie
nt w
hen
mak
ing
deci
sion
s fo
r a
patie
nt w
ithou
t dec
isio
n-m
akin
g ca
paci
ty
Can
des
crib
e th
e re
leva
nt la
w
rega
rdin
g su
rrog
acy
Can
des
crib
e th
e m
oral
just
ifica
tions
fo
r cho
osin
g a
surr
ogat
e
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 40
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d A
sks
the
surro
gate
abo
ut w
hat t
he
patie
nt w
ould
hav
e w
ante
d w
hen
disc
ussi
ng g
oals
of t
hera
py
fello
w36
0 E
valu
atio
n
4.1.
5 R
ecog
nize
s di
ffere
nces
bet
wee
n re
latio
nshi
p-ce
nter
ed d
ialo
gues
in a
dult
and
pedi
atric
pal
liativ
e ca
re
Can
des
crib
e di
ffere
nces
in p
edia
tric
and
adul
t com
mun
icat
ion
abou
t pa
lliativ
e ca
re to
pics
MC
E A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wC
heck
list
eval
uatio
n 4.
2 D
emon
stra
tes
empa
thy
4.
2.1
Use
s em
path
ic a
nd fa
cilit
atin
g ve
rbal
be
havi
ors
such
as:
nam
ing,
affi
rmat
ion,
no
rmal
izat
ion,
refle
ctio
n, s
ilenc
e, li
sten
ing,
se
lf-di
sclo
sure
, and
hum
or in
an
effe
ctiv
e an
d ap
prop
riate
man
ner
Dem
onst
rate
s em
path
ic a
nd
faci
litat
ing
verb
al b
ehav
iors
whe
n gi
ving
bad
new
s
Dem
onst
rate
s th
ese
beha
vior
s in
re
spon
se to
em
path
ic o
ppor
tuni
ties
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
2.2
Em
ploy
s em
path
ic a
nd fa
cilit
atin
g no
n-ve
rbal
beh
avio
rs s
uch
as: t
ouch
, eye
con
tact
, op
en p
ostu
re, a
nd e
ye-le
vel a
ppro
ach
in a
n ef
fect
ive
and
appr
opria
te m
anne
r
Sam
e as
abo
ve
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
3. D
emon
stra
tes
abilit
y to
reco
gniz
e an
d re
spon
d to
ow
n em
otio
ns a
nd th
ose
of
othe
rs
4.3.
1 E
xpre
sses
aw
aren
ess
of o
wn
emot
iona
l st
ate
befo
re, d
urin
g, a
nd a
fter p
atie
nt a
nd
fam
ily e
ncou
nter
s
Can
refle
ct o
n on
e’s
emot
ions
whe
n ta
lkin
g to
pat
ient
or f
amilie
s in
di
scus
sion
s
Che
cklis
tev
alua
tion
4.3.
2 R
efle
cts
on o
wn
emot
ions
afte
r pat
ient
an
d fa
mily
enc
ount
er o
r rel
ated
eve
nt
Che
cklis
tev
alua
tion
4.3.
3 E
ffect
ivel
y pr
oces
ses
own
emot
ions
in
clin
ical
set
ting
in o
rder
to fo
cus
on th
e ne
eds
Bas
ed o
n se
lf re
port
feel
s ab
le to
to
lera
te s
trong
pat
ient
em
otio
ns
Atte
ndin
gph
ysic
ian
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 41
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d of
the
patie
nt a
nd fa
mily
asse
ssm
ent o
ffe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
3.4
Res
pond
s to
requ
ests
to p
artic
ipat
e in
sp
iritu
al o
r rel
igio
us a
ctiv
ities
and
ritu
als,
in a
m
anne
r tha
t pre
serv
es re
spec
t for
bot
h th
e pa
tient
and
fam
ily, a
s w
ell a
s on
e’s
own
inte
grity
and
per
sona
l and
pro
fess
iona
l bo
unda
ries
Can
refle
ct o
n hi
s/he
r abi
lity
to
resp
ond
genu
inel
y w
hen
aske
d to
pa
rtici
pate
in s
pirit
ual/r
elig
ious
ac
tiviti
es.
Is fe
lt by
a S
P to
sho
w re
spec
t whe
n as
ked
to p
artic
ipat
e in
re
ligio
us/s
pirit
ual r
itual
s
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
3.5
Sel
f-cor
rect
s co
mm
unic
atio
n m
iscu
es
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
3.6
Res
pond
s ef
fect
ivel
y to
inte
nse
emot
ions
of p
atie
nts,
fam
ilies,
and
col
leag
ues
Dem
onst
rate
s us
e of
spe
cific
st
rate
gies
to re
spon
d to
em
otio
ns, i
.e.
nam
ing,
refle
ctio
n, a
ffirm
atio
n,
liste
ning
, em
path
y
Is fe
lt by
a S
P to
resp
ond
to e
mot
ions
w
ith s
peci
fic, e
ffect
ive
stra
tegi
es
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
wC
heck
list
eval
uatio
n 36
0 E
valu
atio
n
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 42
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d 4.
4. D
emon
stra
tes
the
abilit
y to
edu
cate
pa
tient
s/fa
milie
s ab
out t
he m
edic
al, s
ocia
l an
d ps
ycho
logi
cal i
ssue
s as
soci
ated
with
lif
e-lim
iting
illn
ess
4.4.
1 D
emon
stra
tes
self-
awar
enes
s an
d ab
ility
to re
cogn
ize
diffe
renc
es b
etw
een
the
clin
icia
n’s
own
and
the
patie
nt a
nd fa
mily
’s
valu
es, a
ttitu
des,
ass
umpt
ions
, hop
es a
nd
fear
s re
late
d to
illn
ess,
dyi
ng, a
nd g
rief
Can
iden
tify
the
diffe
renc
es a
nd
tens
ions
bet
wee
n on
e’s
own
belie
fs
and
the
fam
ilies
rega
rdin
g w
hat
cons
titut
es “g
ood
deat
h”
SP 360
Eva
luat
ion
4.4.
2 R
ecog
nize
s th
e im
porta
nce
of s
ervi
ng
as a
n ed
ucat
or fo
r pat
ient
/fam
ily
Che
cklis
tev
alua
tion
360
Eva
luat
ion
4.4.
3 Id
entif
ies
patie
nts/
fam
ilies’
gap
s in
kn
owle
dge
Ask
s pa
tient
/fam
ilies
if th
ey h
ave
ques
tions
SP Fa
mily
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
4.4.
4 C
omm
unic
ates
kno
wle
dge
to
patie
nts/
fam
ilies
base
d on
the
patie
nt/fa
mily
’s
leve
l of u
nder
stan
ding
Avo
ids
jarg
on in
con
vers
atio
ns w
ith
fam
ilies/
patie
nts
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
4.5
Edu
cate
s pa
tient
s/fa
milie
s a
bout
life
co
mpl
etio
n ta
sks
such
as
com
plet
ion
of
prac
tical
affa
irs a
nd re
latio
nshi
ps,
achi
evem
ent o
f a s
atis
fact
ory
sens
e of
life
co
mpl
etio
n an
d cl
osur
e
Ask
s pa
tient
s ab
out t
heir
desi
re fo
r lif
e co
mpl
etio
n ta
sks
SP Fa
mily
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
4.4.
6 R
ecog
nize
s th
e im
porta
nce
of
ambi
vale
nce
whe
n m
akin
g de
cisi
ons
abou
t he
goal
s of
car
e an
d us
es a
ppro
pria
te s
trate
gies
to
add
ress
it
Rec
ogni
zes
the
impo
rtanc
e of
pa
tient
/fam
ily a
mbi
vale
nce
Can
des
crib
e s
trate
gies
for d
ealin
g w
ith a
mbi
vale
nt fa
milie
s/pa
tient
Can
use
a s
trate
gy fo
r dea
ling
with
am
biva
lent
fam
ilies/
patie
nts
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n
4.4.
7 Id
entif
ies
patie
nts/
fam
ilies
who
may
be
nefit
from
a la
ngua
ge tr
ansl
atio
n se
rvic
e or
in
terp
rete
r
Ask
s ap
prop
riate
ly fo
r a tr
ansl
ator
Can
des
crib
e di
fficu
lties
ass
ocia
ted
with
usi
ng a
tran
slat
or
SP Fam
ilyas
sess
men
t of
fello
w
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 43
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d 36
0 E
valu
atio
n 4.
4.8
Edu
cate
s su
rroga
tes
abou
t the
ir ro
le a
s m
edic
al d
ecis
ion-
mak
ers
Pre
pare
s le
gal s
urro
gate
to fo
cus
on
wha
t pat
ient
wou
ld w
ant i
n th
e gi
ven
situ
atio
n an
d to
exp
ress
thos
e w
ishe
s, s
epar
ate
from
wis
hes
of a
ny
othe
r per
son
invo
lved
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
5 U
ses
age,
gen
der,
and
cultu
rally
-ap
prop
riate
con
cept
s an
d la
ngua
ge w
hen
com
mun
icat
ing
with
fam
ilies
and
patie
nts
4.5.
1 R
outin
ely
asse
sses
pat
ient
s/fa
milie
s to
id
entif
y in
divi
dual
s w
ho m
ight
ben
efit
from
ag
e, g
ende
r, an
d cu
ltura
lly-a
ppro
pria
te
inte
rven
tions
or s
uppo
rt
Ask
if th
ere
are
any
relig
ious
or
spiri
tual
trad
ition
s th
e te
am s
houl
d kn
ow a
bout
whe
n ta
lkin
g to
fam
ilies
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
5.2
Sho
ws
sens
itivi
ty to
dev
elop
men
tal
stag
es a
nd p
roce
sses
in a
ppro
achi
ng
patie
nts/
fam
ilies
Dis
cuss
es is
sues
at d
evel
opm
enta
l le
vel a
ppro
pria
te to
the
indi
vidu
al,
and
dem
onst
rate
s ab
ility
to a
djus
t ex
plan
atio
n/di
scus
sion
bas
ed o
n de
velo
pmen
tal s
tage
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
5.3
App
reci
ates
the
need
to a
djus
t co
mm
unic
atio
n st
rate
gies
bas
ed o
n cu
ltura
l be
liefs
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
6 D
emon
stra
tes
the
abov
e sk
ills in
the
follo
win
g pa
radi
gmat
ic s
ituat
ions
with
pa
tient
s or
fam
ilies
and
docu
men
ts a
n in
form
ativ
e, s
ensi
tive
note
in th
e m
edic
al
reco
rd:
A.
Giv
ing
bad
new
s
B.
Dis
cuss
ing
trans
ition
s in
goa
ls o
f ca
re fr
om a
cur
ativ
e an
d/or
life
pr
olon
ging
focu
s to
pal
liativ
e ca
re
C.
Dea
ling
with
fam
ily m
embe
rs w
ho
wan
t to
prot
ect t
he p
atie
nt fr
om
dist
ress
ing
info
rmat
ion
D.
Dis
cuss
ing
patie
nt w
ishe
s fo
r in
appr
opria
te o
r “fu
tile”
car
e at
the
end
of li
fe
Dis
play
s co
mfo
rt an
d ef
fect
ive
com
mun
icat
ion
skills
in ro
utin
ely
addr
essi
ng th
ese
situ
atio
ns
Doc
umen
ts th
e co
nver
satio
n in
the
med
ical
reco
rd
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Che
cklis
tev
alua
tion
Cha
rt/re
cord
re
view
O
SC
E/S
PM
ini-C
EX
Writ
ing
assi
gnm
ent
SP Fam
ilyas
sess
men
t of
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 44
Itner
pers
onal
and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d E
. A
ddre
ssin
g pa
tient
/fam
ily e
mot
iona
l di
stre
ss a
bout
talk
ing
abou
t dea
th
and
dyin
g an
d en
d-of
-life
issu
es
F.
Intro
duci
ng o
ptio
n of
pal
liativ
e ca
re
cons
ulta
tion
G
. D
iscu
ssin
g go
als
of c
are
incl
udin
g ad
vanc
e ca
re p
lann
ing
and
re
susc
itatio
n st
atus
H.
Dis
cuss
ing
appr
opria
te c
are
setti
ngs
I. D
iscu
ssin
g th
e en
d-of
-life
car
e ne
eds
of a
dyi
ng c
hild
with
par
ents
J.
D
iscu
ssin
g th
e ne
eds
of m
inor
ch
ildre
n of
dyi
ng a
dults
K
. W
ithho
ldin
g or
with
draw
ing
of a
ny
life-
sust
aini
ng th
erap
y L.
C
ontin
uing
life
-sus
tain
ing
ther
apy
with
focu
s on
pal
liatio
n M
. D
iscu
ssin
g en
rollm
ent i
nto
hosp
ice
N
. D
ealin
g w
ith re
ques
ts fo
r phy
sici
an
aid
in d
ying
O
. D
iscu
ssin
g pa
lliativ
e se
datio
n P
. D
iscu
ssin
g ar
tific
ial h
ydra
tion
and
nutri
tion
Q.
Dis
cuss
ing
seve
re s
pirit
ual o
r ex
iste
ntia
l suf
ferin
g R
. R
efer
ring
to ta
sks
of li
fe re
view
, co
mpl
etio
n of
per
sona
l affa
irs,
incl
udin
g re
latio
nshi
ps a
nd
sexu
ality
, and
soc
ial a
nd s
pirit
ual
aspe
cts
of li
fe c
ompl
etio
n an
d cl
osur
e
S.
Say
ing
good
-bye
to p
atie
nts
or
fam
ilies
T.
Pro
noun
cing
dea
th in
pre
senc
e of
pa
tient
’s fa
mily
fello
w36
0 ev
alua
tion
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wC
heck
list
eval
uatio
n C
hart
/reco
rd
revi
ew
OS
CE
/SP
Min
i-CE
XW
ritin
gas
sign
men
t
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 45
Itn
rm
mun
icat
ion
Skill
s e
pers
onal
and
Co
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
U.
Writ
ing
cond
olen
ce n
otes
and
m
akin
g be
reav
emen
t cal
ls
4.7.
Org
aniz
es a
nd le
ads
or c
o-fa
cilit
ates
a
fam
ily m
eetin
g 4.
7.1
Iden
tifie
s w
hen
a fa
mily
mee
ting
is
need
ed
App
ropr
iate
ly in
itiat
es a
rran
gem
ents
fo
r fam
ily m
eetin
gs
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Min
i-CE
XP
eer
asse
ssm
ent o
f fe
llow
SP Fam
ilyas
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
7.2
Iden
tifie
s ap
prop
riate
goa
ls fo
r a fa
mily
m
eetin
gA
ble
to d
efin
e g
oals
for a
giv
en
fam
ily m
eetin
gA
ttend
ing
phys
icia
n as
sess
men
t of
fello
wM
ini-C
EX
Pee
ras
sess
men
t of
fello
wSP Fa
mily
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
4.7.
3 D
emon
stra
tes
a st
ep-w
ise
appr
oach
in
lead
ing
a fa
mily
mee
ting
Em
ploy
s an
org
aniz
ed a
ppro
ach
in
lead
ing
a fa
mily
mee
ting
Min
i-CE
XO
SC
E/S
PP
eer
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
Fam
ily
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 46
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d as
sess
men
t of
fello
w4.
7.4
Dem
onst
rate
s te
chni
ques
for m
edia
ting
intra
-fam
ily o
r fam
ily-h
ealth
car
e te
am c
onfli
ct
Em
ploy
s an
d id
entif
ies
spe
cific
st
rate
gies
for m
edia
ting
fam
ily-
heal
thca
re p
rofe
ssio
nal c
onfli
cts
Min
i-CE
XO
SC
E/S
PA
ttend
ing
phys
icia
n as
sess
men
t of
fello
w36
0 E
valu
atio
n Fa
mily
asse
ssm
ent o
f fe
llow
4.7.
5 D
ocum
ents
the
cour
se a
nd o
utco
me
of
a fa
mily
mee
ting
in th
e m
edic
al re
cord
R
ecor
ds im
porta
nt p
roce
ss a
nd
outc
ome
poin
ts fr
om a
fam
ily m
eetin
g in
the
med
ical
reco
rd
Cha
rt/re
cord
re
view
P
eer
asse
ssm
ent o
f fe
llow
4.8
Col
labo
rate
s ef
fect
ivel
y w
ith o
ther
s as
m
embe
r or l
eade
r of I
DT
4.
8.1
Fac
ilitat
es e
ffici
ent t
eam
mee
tings
D
ispl
ays
abilit
y to
def
ine
and
follo
w
agen
da a
s ph
ysic
ian
lead
er to
ac
hiev
e ef
ficie
nt te
am m
eetin
gs
Dem
onst
rate
s st
rate
gy fo
r red
irect
ing
team
mee
ting
whe
n th
e di
scus
sion
is
tang
entia
l
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w4.
8.2
Acc
epts
and
sol
icits
insi
ghts
from
In
terd
isci
plin
ary
Team
(ID
T) m
embe
rs
Dem
onst
rate
s op
enne
ss to
inpu
t fro
m
IDT
mem
bers
rega
rdin
g a
patie
nt’s
P
eer
asse
ssm
ent o
f
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 47
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d re
gard
ing
patie
nt a
nd fa
mily
nee
ds in
evo
lvin
g th
e pa
tient
’s p
lan
of c
are
plan
App
ropr
iate
ly re
ques
ts in
put f
rom
IDT
mem
bers
rega
rdin
g pa
tient
’s p
lan
of
care
fello
w36
0 E
valu
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
w4.
8.3
Man
ages
and
reco
gniz
es th
e ne
ed fo
r co
nflic
t res
olut
ion
in ID
T m
eetin
gs
Iden
tifie
s an
d em
ploy
s ef
fect
ive
stra
tegi
es fo
r con
flict
reso
lutio
n in
ID
T m
eetin
gs
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n A
ttend
ing
phys
icia
n as
sess
men
t of
fello
wW
ritin
gas
sign
men
t 4.
8.4
Pro
vide
s co
nstru
ctiv
e fe
edba
ck to
IDT
mem
bers
Dem
onst
rate
s an
effe
ctiv
e st
rate
gy
for d
eliv
erin
g fe
edba
ck in
IDT
360
Eva
luat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 48
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d 4.
8.5
Acc
epts
feed
back
from
IDT
mem
bers
R
espo
nds
to fe
edba
ck fr
om ID
T m
embe
rs in
a, r
espe
ctfu
l man
ner
360
Eva
luat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
4.9
Dev
elop
s ef
fect
ive
rela
tions
hips
with
re
ferr
ing
phys
icia
ns, c
onsu
ltant
phy
sici
ans,
an
d ot
her h
ealth
car
e pr
ovid
ers
4.9.
1 P
rovi
des
a co
ncis
e ve
rbal
his
tory
and
ph
ysic
al e
xam
pre
sent
atio
n fo
r a n
ew
pallia
tive
care
pat
ient
Can
mak
e a
conc
ise
patie
nt
pres
enta
tion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n M
ini-C
EX
4.9.
2 S
umm
ariz
es th
e ac
tive
pallia
tive
care
is
sues
and
trea
tmen
t rec
omm
enda
tions
for a
kn
own
patie
nt in
sig
ning
out
to o
r upd
atin
g a
colle
ague
Pro
vide
s an
info
rmat
ive
sum
mar
y of
ac
tive
patie
nt is
sues
and
in
terv
entio
ns to
faci
litat
e tra
nsfe
r of
care
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n M
ini-C
EX
4.9.
3 C
omm
unic
ates
with
refe
rring
and
co
nsul
tant
clin
icia
ns a
bout
the
care
pl
an/re
com
men
datio
ns fo
r the
pat
ient
and
fa
mily
App
ropr
iate
ly in
itiat
es c
omm
unic
atio
n w
ith o
ther
clin
icia
ns a
bout
car
e pl
ans
for a
pat
ient
and
fam
ily
Em
ploy
s ef
fect
ive
com
mun
icat
ion
stra
tegi
es w
hen
disc
ussi
ng c
are
plan
s w
ith o
ther
clin
icia
ns
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 49
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
9.4
Com
mun
icat
es w
ith h
ealth
car
e pr
ovid
ers
whe
n th
ere
is d
isag
reem
ent a
bout
tre
atm
ent p
lans
App
ropr
iate
ly a
ntic
ipat
es
disa
gree
men
t abo
ut tr
eatm
ent p
lans
Effe
ctiv
ely
nego
tiate
s di
ffere
nces
in
opin
ion
rega
rdin
g tre
atm
ent p
lans
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n C
heck
list
eval
uatio
n 4.
9.5
Wor
ks to
war
d co
nsen
sus
build
ing
Atte
ndin
g
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 50
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d ab
out t
reat
men
t pla
ns a
nd g
oals
of c
are
M
aint
ains
a p
ositi
ve fo
cus
on th
e ne
eds
of p
atie
nt a
nd fa
mily
whe
n th
ere
are
disa
gree
men
ts
phys
icia
n as
sess
men
t of
fello
wP
eer
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
9.6
Sup
ports
and
em
pow
ers
colle
ague
s to
le
ad a
nd p
artic
ipat
e in
fam
ily m
eetin
gs
Enc
oura
ges
rele
vant
phy
sici
ans
and
staf
f to
parti
cipa
te in
a fa
mily
mee
ting
Adv
ocat
es fo
r pre
-mee
tings
with
cl
inic
ian
parti
cipa
nts
prio
r to
fam
ily
mee
tings
whe
n ap
prop
riate
Dem
onst
rate
s fle
xibi
lity
in ro
le d
urin
g fa
mily
mee
tings
, inc
ludi
ng a
bilit
y to
le
ad o
r sup
port
Cou
nsel
s cl
inic
ian
colle
ague
s in
ef
fect
ive
lead
ersh
ip o
f fam
ily
mee
tings
whe
n th
e op
portu
nity
aris
es
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n
Atte
ndin
gph
ysic
ian
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 51
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d as
sess
men
t of
fello
wP
eer
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
9.7
Elic
its c
once
rns
from
and
pro
vide
s em
otio
nal s
uppo
rt an
d ed
ucat
ion
to s
taff
arou
nd d
iffic
ult d
ecis
ions
and
car
e sc
enar
ios
Rou
tinel
y as
sess
es s
taff
in a
giv
en
case
for n
eede
d em
otio
nal s
uppo
rt an
d pr
ovid
es w
hen
need
ed
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
10 M
aint
ains
com
preh
ensi
ve, t
imel
y,
and
legi
ble
med
ical
reco
rds
4.10
.1 D
ocum
ents
legi
ble
note
s in
the
med
ical
reco
rd in
a ti
mef
ram
e co
nsis
tent
with
in
divi
dual
pro
gram
and
inst
itutio
nal
requ
irem
ents
and
regu
lato
ry a
genc
ies
Ent
ers
legi
ble
note
s in
the
med
ical
re
cord
in a
n ap
prop
riate
tim
efra
me
C
hart/
reco
rd
revi
ew
Pee
ras
sess
men
t of
fello
w36
0 E
valu
atio
n 4.
10.2
Ada
pts
med
ical
reco
rd d
ocum
enta
tion
in d
iffer
ent s
ettin
gs (h
ospi
ce, h
ospi
tal,
hom
e)
Com
mun
icat
es re
leva
nt m
edic
al
reco
rd in
form
atio
n in
a fo
rmat
or
prot
ocol
app
ropr
iate
to e
ach
pallia
tive
care
set
ting
Cha
rt/re
cord
re
view
P
eer
asse
ssm
ent o
f fe
llow
360
Eva
luat
ion
4.10
.3 A
ddre
sses
the
maj
or d
omai
ns o
f A
ttend
s to
all
rele
vant
dom
ains
of
Cha
rt/re
cord
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 52
Inte
rper
sona
l and
Com
mun
icat
ion
Skill
s C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d pa
lliativ
e ca
re, (
as p
er th
e N
atio
nal
Con
sens
us P
roje
ct) a
s ap
prop
riate
, in
the
initi
al h
isto
ry a
nd p
hysi
cal e
xam
pallia
tive
care
in th
e in
itial
his
tory
and
ph
ysic
al e
xam
re
view
P
eer
asse
ssm
ent o
f fe
llow
Min
i-CE
X4.
10.4
Con
sist
ently
incl
udes
all
rele
vant
do
mai
ns o
f pal
liativ
e ca
re (a
s pe
r the
Nat
iona
l C
onse
nsus
Pro
ject
) in
prog
ress
not
es a
nd
follo
w-u
p do
cum
enta
tion
Atte
nds
to a
ll re
leva
nt d
omai
ns o
f pa
lliativ
e ca
re in
pro
gres
s no
tes
C
hart/
reco
rd
revi
ew
Pee
ras
sess
men
t of
fello
wM
ini-C
EX
4.10
.5 D
ocum
ents
dea
th p
rono
unce
men
t in
the
med
ical
reco
rd a
nd c
ompl
etes
dea
th
certi
ficat
e in
a c
orre
ct a
nd ti
mel
y
Com
plet
es d
ocum
enta
tion
of d
eath
pr
onou
ncem
ent i
n th
e m
edic
al
reco
rd, i
n a
timel
y m
anne
r
Cor
rect
ly c
ompl
etes
dea
th c
ertif
icat
e in
a ti
mel
y m
anne
r
Cha
rt/re
cord
re
view
P
eer
asse
ssm
ent o
f fe
llow
Cha
rt/re
cord
re
view
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 53
Prof
essi
onal
ism
C
ompe
tenc
y
Sub-
com
pete
ncy
Sam
ple
Beh
avio
r A
sses
smen
t M
etho
d 5.
1 A
chie
ves
appr
opria
te b
alan
ce b
etw
een
need
s of
pat
ient
s/fa
mily
/team
, whi
le
bala
ncin
g on
e’s
own
need
for s
elf-c
are
5.1.
1 R
ecog
nize
s th
e si
gns
of fa
tigue
, bu
rnou
t, an
d pe
rson
al d
istre
ss a
nd m
akes
ad
just
men
ts to
dea
l with
it
Iden
tifie
s pe
rson
al v
ulne
rabi
litie
s th
at
may
lead
to b
urno
ut
Des
crib
es s
igns
of b
urno
ut u
sing
pe
rson
al e
xam
ples
Writ
ing
assi
gnm
ent
MC
E
5.1.
2 D
escr
ibes
effe
ctiv
e st
rate
gies
for s
elf-
care
, inc
ludi
ng b
alan
ce, e
mot
iona
l sup
port,
an
d de
alin
g w
ith b
urn-
out a
nd p
erso
nal l
oss
The
train
ee w
ill de
scrib
e pe
rson
al
activ
ities
that
sup
port
a se
nse
of
pers
onal
bal
ance
Writ
ing
assi
gnm
ent
5.1.
3 C
ontri
bute
s to
team
wel
lnes
s E
xhib
its c
arin
g be
havi
ors
tow
ard
othe
r te
am m
embe
rs
360
Eva
luat
ion
5.1.
4 E
xpla
ins
how
to s
et a
ppro
pria
te
boun
darie
s w
ith c
olle
ague
s an
d w
ith p
atie
nts
and
fam
ilies
Col
leag
ues
will
repo
rt th
at th
e tra
inee
de
mon
stra
tes
appr
opria
te a
ttent
ion
to
prof
essi
onal
bou
ndar
ies
360
Eva
luat
ion
5.2
Rec
ogni
zes
own
role
and
the
role
of t
he
syst
em in
dis
clos
ure
and
prev
entio
n of
m
edic
al e
rror
5.2.
1 A
sses
ses
pers
onal
beh
avio
r and
ac
cept
s re
spon
sibi
lity
for e
rror
s w
hen
appr
opria
te
The
train
ee re
ceiv
es fe
edba
ck w
ithou
t de
fens
iven
ess
360
Eva
luat
ion
Cha
rt st
imul
ated
re
call
exam
inat
ion
Writ
ing
assi
gnm
ent
5.2.
2 D
iscl
oses
med
ical
erro
rs in
acc
ord
with
in
stitu
tiona
l pol
icie
s an
d pr
ofes
sion
al e
thic
s 36
0E
valu
atio
n
5.3
Dem
onst
rate
s ac
coun
tabi
lity
to p
atie
nts,
so
ciet
y, a
nd th
e pr
ofes
sion
; and
a
com
mitm
ent t
o ex
celle
nce
Trai
nee
show
s co
mm
itmen
t to
own
prof
essi
onal
gro
wth
thro
ugh
read
ing,
at
tend
ance
at e
duca
tiona
l pro
gram
s an
d ot
her a
ppro
pria
te a
ctiv
ities
, and
br
ings
new
und
erst
andi
ngs
back
to th
e te
am.
Atte
ndan
ce lo
g,
360
Eva
luat
ion
5.4
Des
crib
es ro
le o
f hos
pice
med
ical
di
rect
or in
term
s of
qua
lity
of c
are,
co
mpl
ianc
e, a
nd c
omm
unic
atio
n w
ith o
ther
pr
ofes
sion
als
MC
E
5.5
Ful
fills
pro
fess
iona
l com
mitm
ents
5.
5.1
Res
pond
s in
a ti
mel
y m
anne
r to
requ
ests
from
pat
ient
s an
d fa
milie
s fo
r m
edic
al in
form
atio
n
360
Eva
luat
ion
5.5.
2 R
espo
nds
to re
ques
ts fo
r hel
p fro
m
colle
ague
s 36
0E
valu
atio
n
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 54
Prof
essi
onal
ism
C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d 5.
5.3
Dem
onst
rate
s ac
coun
tabi
lity
for
pers
onal
act
ions
and
pla
ns
360
Eva
luat
ion
5.5.
4 F
ulfil
ls p
rofe
ssio
nal r
espo
nsib
ilitie
s an
d w
orks
effe
ctiv
ely
as a
team
mem
ber
360
Eva
luat
ion
5.5.
5 A
ddre
sses
con
cern
s ab
out q
ualit
y of
ca
re a
nd im
paire
d pe
rform
ance
am
ong
colle
ague
s
360
Eva
luat
ion
5.5.
6 T
reat
s co
-wor
kers
with
resp
ect,
dign
ity,
and
com
pass
ion
360
Eva
luat
ion
5.6
Dem
onst
rate
s kn
owle
dge
of e
thic
s an
d la
w th
at s
houl
d gu
ide
care
of p
atie
nts,
in
clud
ing
spec
ial c
onsi
dera
tions
aro
und
thes
e is
sues
in p
edia
tric,
adu
lt, a
nd g
eria
tric
pallia
tive
care
, inc
ludi
ng:
Info
rmed
Con
sent
C
onfid
entia
lity
Dec
isio
n-m
akin
g ca
paci
ty
Dec
isio
n-m
akin
g fo
r chi
ldre
n an
d
adol
esce
nts,
and
old
er p
atie
nts
with
de
men
tia
Lim
its o
f sur
roga
te d
ecis
ion-
mak
ing
Tru
th-te
lling
F
oreg
oing
life
-sus
tain
ing
treat
men
t M
edic
al fu
tility
U
se o
f arti
ficia
l hyd
ratio
n an
d nu
tritio
n
Phy
sici
an-a
ssis
ted
suic
ide
Eut
hana
sia
Prin
cipl
e of
dou
ble
effe
ct
Org
an d
onat
ion
R
esea
rch
ethi
cs
Nur
se-p
hysi
cian
col
labo
ratio
n In
dica
tions
for r
efer
ring
to a
n et
hics
co
nsul
tant
C
onfli
cts
of in
tere
st
360
Eva
luat
ion
M
CE
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 55
Prof
essi
onal
ism
C
ompe
tenc
y
Sub-
com
pete
ncy
Ass
essm
ent
Sam
ple
Beh
avio
r M
etho
d
5.7
Dem
onst
rate
s re
spec
t and
com
pass
ion
tow
ards
all
patie
nts
and
thei
r fam
ilies,
as
wel
l as
tow
ards
oth
er c
linic
ians
5.7.
1 D
emon
stra
tes
willi
ngne
ss a
nd a
bilit
y to
id
entif
y ow
n as
sum
ptio
ns, i
ndiv
idua
l and
cu
ltura
l val
ues,
hop
es a
nd fe
ars
rela
ted
to
life-
limiti
ng il
lnes
s an
d in
jury
, dis
abilit
y, d
ying
, de
ath
and
grie
f
360
Eva
luat
ion
Pat
ient
/Fam
ilyas
sess
men
t of
fello
w
5.7.
2 D
ispl
ays
sens
itivi
ty to
issu
es
surro
undi
ng a
ge, e
thni
city
, sex
ual o
rient
atio
n,
cultu
re, s
pirit
ualit
y an
d re
ligio
n, a
nd d
isab
ility
Pat
ient
/Fam
ilyas
sess
men
t of
fello
ws
5.7.
3 E
ffect
ivel
y co
mm
unic
ates
the
mis
sion
of
pal
liativ
e ca
re to
hos
pita
l adm
inis
trato
rs,
clin
icia
ns, a
nd c
omm
unity
at l
arge
360
Eva
luat
ion
5.8
Dem
onst
rate
s th
e ca
paci
ty to
refle
ct o
n pe
rson
al a
ttitu
des,
val
ues,
stre
ngth
s,
vuln
erab
ilitie
s, a
nd p
erso
nal e
xper
ienc
es to
op
timiz
e pe
rson
al w
elln
ess
and
capa
city
to
mee
t the
nee
ds o
f pat
ient
s an
d fa
milie
s.
Writ
ing
assi
gnm
ent
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 56
Syst
ems-
Bas
ed P
ract
ice
Com
pete
ncy
Su
b-co
mpe
tenc
y Sa
mpl
e B
ehav
ior
Ass
essm
ent
Met
hod
6.1
Dem
onst
rate
s ca
re th
at is
cos
t-effe
ctiv
e an
d re
pres
ents
bes
t pra
ctic
es
6.1.
1 R
ecog
nize
s re
lativ
e co
sts
of
med
icat
ions
and
oth
er
ther
apeu
tics/
inte
rven
tions
Arr
ange
s co
mm
on m
edic
atio
ns in
or
der o
f rel
ativ
e co
st
MC
E
6.1.
2 Im
plem
ents
bes
t evi
denc
e ba
sed
prac
tices
for c
omm
on p
allia
tive
med
icin
e cl
inic
al s
cena
rios
acro
ss s
ettin
gs
Dem
onst
rate
s ab
ility
to d
evel
op p
lan
of c
are
cons
iste
nt w
ith e
vide
nce
base
C
hart/
reco
rd
revi
ew
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
6.1.
3 E
xpla
ins
the
ratio
nale
for t
he u
se o
f m
edic
atio
n fo
rmul
arie
s D
iffer
entia
tes
betw
een
med
s on
fo
rmul
ary
and
not,
expl
ains
reas
on
why
cho
ices
wer
e m
ade
MC
E S
tand
ardi
zed
oral
ex
am6.
1.4
Iden
tifie
s si
mila
ritie
s an
d di
ffere
nces
be
twee
n re
imbu
rsem
ents
for p
allia
tive
med
icin
e, h
ospi
ce, h
ospi
tal,
hom
e he
alth
, an
d lo
ng te
rm c
are
Def
ines
reim
burs
emen
t pra
ctic
es fo
r va
rious
set
tings
whe
re p
allia
tive
med
icin
e is
pra
ctic
ed
Exp
lain
s re
imbu
rsem
ent p
rinci
ples
to
patie
nts
and
thei
r fam
ilies
MC
E
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Fam
ilyas
sess
men
t of
fello
w6.
1.5
Des
crib
es b
asic
con
cept
s an
d pa
ttern
s of
phy
sici
an b
illing
, cod
ing
and
reim
burs
emen
t acr
oss
setti
ngs
Out
lines
key
diff
eren
ces
betw
een
phys
icia
n bi
lling
prac
tices
in d
iffer
ent
setti
ngs
of c
are
MC
ES
tand
ardi
zed
oral
ex
am6.
2 E
valu
ates
and
impl
emen
ts s
yste
ms
impr
ovem
ent b
ased
on
clin
ical
pra
ctic
e or
pa
tient
and
fam
ily s
atis
fact
ion
data
, in
pe
rson
al p
ract
ice,
team
pra
ctic
e, a
nd w
ithin
in
stitu
tiona
l set
tings
6.2.
1 R
evie
ws
perti
nent
clin
ical
or
patie
nt/fa
mily
sat
isfa
ctio
n da
ta a
bout
pe
rson
al, t
eam
, or i
nstit
utio
nal p
ract
ice
patte
rns.
Sys
tem
atic
ally
eva
luat
es c
urre
nt
prac
tice
and
desi
gns
way
s to
impr
ove
wea
knes
ses
with
in p
ract
ice
PIM
Cha
rt/re
cord
re
view
6.3
Inte
grat
es k
now
ledg
e of
hea
lth c
are
6.3.
1 D
escr
ibes
pol
icie
s an
d pr
oced
ures
of
List
s el
emen
ts o
f car
e at
com
mon
ly
MC
E
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 57
Syst
ems-
Bas
ed P
ract
ice
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
syst
em in
dev
elop
ing
plan
of c
are
perti
nent
hea
lth c
are
syst
ems
enco
unte
red
syst
ems
of c
are
with
in
inst
itutio
nal e
nviro
nmen
t 6.
3.2
Des
crib
es p
hilo
soph
y, a
dmis
sion
s cr
iteria
, ran
ge o
f ser
vice
s, a
nd s
truct
ure
of
hosp
ice
care
Sum
mar
izes
pos
sibi
litie
s of
car
e an
d st
reng
ths/
wea
knes
ses
of c
omm
only
en
coun
tere
d sy
stem
s of
car
e w
ithin
in
stitu
tiona
l env
ironm
ent
Cor
rect
ly d
escr
ibes
bas
ics
of h
ospi
ce
as o
ptio
n fo
r car
e
Sta
ndar
dize
d or
al
exam
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
Che
cklis
t ev
alua
tion
6.3.
3 R
ecog
nize
s re
sour
ces
and
barr
iers
re
leva
nt to
the
care
of s
peci
aliz
ed
popu
latio
ns in
hos
pice
and
pal
liativ
e m
edic
ine,
and
has
bas
ic k
now
ledg
e of
how
to
mob
ilize
appr
opria
te s
uppo
rt fo
r the
se
popu
latio
ns (e
.g. p
edia
tric
patie
nts,
HIV
pa
tient
s, e
tc.)
Exp
lain
s ba
rrie
rs to
car
e fo
r cer
tain
po
pula
tions
and
dem
onst
rate
s ab
ility
to
pro
vide
reso
urce
s/su
ppor
t
Glo
bal r
atin
g sc
ale
Che
cklis
tev
alua
tion
6.4
Dem
onst
rate
s kn
owle
dge
of th
e va
rious
se
tting
s an
d re
late
d st
ruct
ures
for
orga
nizi
ng, r
egul
atin
g, a
nd fi
nanc
ing
care
for
patie
nts
at th
e en
d of
life
6.4.
1 D
escr
ibes
diff
eren
ces
in a
dmis
sion
cr
iteria
for v
ario
us s
ettin
gs s
uch
as h
ospi
tals
, pa
lliativ
e ca
re u
nits
, ski
lled-
nurs
ing
and
assi
sted
-livi
ng fa
cilit
ies,
acu
te/s
ub-a
cute
re
hab
faci
litie
s, a
nd lo
ng-te
rm a
cute
car
e se
tting
s as
wel
l as
tradi
tiona
l hom
e ho
spic
e
Dis
tingu
ishe
s be
twee
n se
rvic
es
prov
ided
at e
ach
locu
s of
car
e an
d de
term
ines
whi
ch s
ite o
f car
e is
mos
t ap
plic
able
for e
ach
patie
nt
Glo
bal r
atin
g sc
ale
Che
cklis
tev
alua
tion
Cha
rt re
cord
re
view
6.
5 C
olla
bora
tes
effe
ctiv
ely
with
all
elem
ents
of
the
pallia
tive
care
con
tinuu
m, i
nclu
ding
ho
spita
ls, p
allia
tive
care
uni
ts, n
ursi
ng
hom
es, h
ome
and
inpa
tient
hos
pice
, and
ot
her c
omm
unity
reso
urce
s
6.5.
1 E
ffect
ivel
y ut
ilizes
mem
bers
of
inte
rdis
cipl
inar
y te
am to
cre
ate
smoo
th a
nd
effic
ient
tran
sitio
ns a
cros
s he
alth
car
e se
tting
s fo
r pat
ient
s an
d fa
milie
s
360
Eva
luat
ion
Cha
rt/re
cord
re
view
6.5.
2 C
omm
unic
ates
with
car
e m
anag
ers/
appr
opria
te s
taff
acro
ss s
ites
to
enab
le s
eam
less
tran
sitio
ns b
etw
een
setti
ngs
Dem
onst
rate
s ab
ility
to w
ork
in
inte
rdis
cipl
inar
y te
am to
cre
ate
effe
ctiv
e ca
re p
lans
and
opt
imiz
e tra
nsiti
ons
betw
een
setti
ngs
Pee
r ass
essm
ent
of fe
llow
C
onsu
ltant
as
sess
men
t of
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 58
Syst
ems-
Bas
ed P
ract
ice
Com
pete
ncy
Su
b-co
mpe
tenc
y A
sses
smen
t Sa
mpl
e B
ehav
ior
Met
hod
fello
w
360
Eva
luat
ion
6.5.
3 C
omm
unic
ates
with
clin
icia
ns a
t tim
e of
ca
re tr
ansi
tions
to c
larif
y an
d co
ordi
nate
car
e pl
an a
cros
s se
tting
s
Com
mun
icat
es w
ith c
linic
ians
at o
ther
se
tting
s at
tim
e of
tra
nsiti
on to
pr
eser
ve m
edic
al p
lan
Pee
r ass
essm
ent
of fe
llow
C
onsu
ltant
as
sess
men
t of
fello
w6.
6 A
dvoc
ates
for q
ualit
y pa
tient
and
fam
ily
care
and
ass
ists
pat
ient
s an
d fa
mili
es in
de
alin
g w
ith s
yste
m c
ompl
exiti
es
6.6.
1 C
omm
unic
ates
and
sup
ports
pat
ient
an
d fa
mily
dec
isio
n-m
akin
g ab
out d
isch
arge
pl
anni
ng –
incl
udin
g se
tting
s of
car
e, s
ervi
ce
optio
ns, a
nd re
imbu
rsem
ent/p
ayer
sys
tem
s
Arra
nges
fam
ily m
eetin
gs re
latin
g to
di
scha
rge
and
runs
them
effe
ctiv
ely
and
smoo
thly
Pat
ient
/Fam
ilyas
sess
men
t of
fello
ws
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
6.6.
2 C
oord
inat
es a
nd fa
cilit
ates
dia
logu
e be
twee
n pa
tient
s/fa
milie
s an
d se
rvic
e pr
ovid
er re
pres
enta
tives
(e.g
. hos
pice
liai
son
nurs
es, n
ursi
ng h
ome
adm
inis
trato
rs; a
nd
inte
r-ho
spita
l dep
artm
ents
incl
udin
g bu
t not
lim
ited
to IC
U, i
nter
med
iate
car
e, e
mer
genc
y de
partm
ent)
Dem
onst
rate
s ab
ility
to d
eter
min
e w
hich
ser
vice
s ar
e ap
prop
riate
and
th
en fa
cilit
ates
(and
par
ticip
ates
in, a
s ap
prop
riate
) mee
tings
with
fam
ily a
nd
repr
esen
tativ
es o
f ser
vice
pro
vide
r.
Pat
ient
/Fam
ilyas
sess
men
t of
fello
ws
360
Eva
luat
ion
6.7
Par
tner
s w
ith h
ealth
car
e m
anag
ers
and
heal
th c
are
prov
ider
s to
ass
ess,
coo
rdin
ate,
an
d im
prov
e pa
tient
saf
ety
and
heal
th c
are,
an
d un
ders
tand
s ho
w th
ese
activ
ities
can
af
fect
sys
tem
per
form
ance
6.7.
1 D
escr
ibes
hos
pita
l and
pal
liativ
e ca
re
prog
ram
con
tinuo
us q
ualit
y im
prov
emen
t pr
ogra
ms
and
thei
r goa
ls a
nd p
roce
sses
Dis
cuss
es lo
cal o
r nat
iona
l qua
lity
impr
ovem
ent p
roje
cts
and
sugg
ests
w
ays
that
car
e ca
n co
ntin
ue to
be
impr
oved
Atte
ndin
gph
ysic
ian
asse
ssm
ent o
f fe
llow
MC
E S
tand
ardi
zed
oral
ex
am
6.7.
2 D
emon
stra
tes
abilit
y to
wor
k w
ith
man
ager
s of
var
ying
dis
cipl
ines
to im
prov
e pa
tient
saf
ety
and
syst
em-b
ased
fact
ors
that
Iden
tifie
s pr
oble
ms
with
sys
tem
fa
ctor
s th
at a
ffect
pat
ient
saf
ety
and
need
impr
ovem
ent.
360
Eva
luat
ion
Atte
ndin
g
Rev
ised
: 9/1
9/20
09
Mea
sura
ble
Out
com
es V
ersi
on 2
.3 fo
r HP
M C
ompe
tenc
ies
Pag
e 59
Rev
ised
: 9/1
9/20
09
Syst
ems-
Bas
ed P
ract
ice
Com
pete
ncy
Su
b-co
mpe
tenc
y Sa
mpl
e B
ehav
ior
Ass
essm
ent
Met
hod
affe
ct c
are
deliv
ery
phys
icia
n as
sess
men
t of
fello
w