Why We Need QI Collaboratives: Guests Steve Pantilat, David Currow, and Arif Kamal
GeriPal - A Geriatrics and Palliative Medicine Podcast
Release Date: 01/08/2026
GeriPal - A Geriatrics and Palliative Medicine Podcast
Philippe Pinel that “It is an art of no little importance to administer medicines properly, but it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them.” This insight remains profoundly relevant today, especially in hospice care, where inappropriate prescribing is a common issue. Studies show that 20%–70% of hospice patients receive at least one unnecessary medication near the end of life, including drugs like antihypertensives, statins, and vitamins. In this episode of the GeriPal Podcast, we tackle the pressing topic of...
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Do you think your hospital should allow unilateral DNR orders? Under what circumstances? Through what process? Do you think that when you obtain the assent of a family to not code their loved one, that assent DNR should be counted as a unilateral DNR order? Should we document unilateral DNR and the rationale? Why for DNR, when we don’t document unilateral dialysis not offered, or unilateral no ECMO offered? Is the assent of a family member to a statement that we will not code their loved one a nudge, and is the assent approach ? Reasonable people will disagree, as we do on this...
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The idea of embedding various forms of non-emergency care in the emergency department makes a WORLD of sense. If an older adult comes into the ED with a fall, the minimum the ED has to do is address the fall injury and send them out. But many emergency providers realize this is often a band aid. They see that patient again the next time they fall. And again. And again. The same could be said for the patient who is malnourished and dehydrated and admitted for “failure to thrive,” again. And again. Our two guests today, Liz Goldberg and Lauren Southerland, both...
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Today we interviewed Bob Wachter about his book, “.” You may recall we , and at that time he was on the fence about AI - more promise or more peril for healthcare? As his book’s title suggests, he’s come down firmly on the promise side of the equation. On our podcast we discuss: Why Bob wrote this book, at this time, and concerns about writing a static book about AI and Healthcare, a field that is dynamic and shifting rapidly. He’s right though - we’ve not had a “ChatGPT”-launch type moment recently. Top 5 or so ways in which Bob uses AI for work,...
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Recent randomized controlled trials have shown that routine perioperative palliative care does not improve outcomes for patients undergoing curative-intent cancer surgery. No, that wasn’t a typo. Regardless of how the data were analyzed, the findings remained consistent: perioperative palliative care DID NOT improve outcomes in the only two randomized controlled trials conducted in this area—the and trials. Null trials like these often receive less attention in academic and clinical settings, but they can be profoundly practice-changing. Consider the . While some have argued it...
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“I just want to say one word to you. One word. Plastics… There's a great future in plastics.” This iconic line from the movie The Graduate is at the top of my mind when I think about where we are heading in healthcare. I’ve interpreted “plastics” as symbolizing a dystopian, mass-produced future of medicine—where artificiality and inauthenticity dominate in the pursuit of efficiency and profit margins. After listening to today’s podcast on the growth of community-based palliative care, I find my perspective shifting on this quote. Perhaps the advice given for a...
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The only certainty in medicine is uncertainty. It touches every aspect of clinical practice, from diagnosis to treatment to prognosis. Despite this, many clinicians view uncertainty as something to tolerate at best or eliminate at worst. But what if we need to rethink and reframe our relationship with uncertainty in medicine? In this episode, we sit down with Jonathan Ilgen and Gurpreet Dhaliwal, co-authors of the New England Journal of Medicine article, “.” Together, we explore the nature of uncertainty in clinical practice, its effects on trainees and seasoned clinicians, and strategies...
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In a recent episode of the GeriPal podcast, we explored —and, if so, how to save it—with guests Ira Byock, Kristi Newport, and Brynn Bowman. Today, we shift focus to one actionable way to improve palliative care: through quality improvement (QI) collaboratives, registries, and benchmarking. To guide this discussion, we’ve invited three leading experts in the field—Drs. Steve Pantilat, David Currow, and Arif Kamal—who bring invaluable experience as pioneers in developing QI collaboratives and registries. Together, they authored a recent paper in JPSM titled “,” which...
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Have you had one of those consults in which you’re thinking, huh, sounds like the patient’s goals are clear, it’s really that the clinician consulting us disagrees with those goals? To what extent is it our job as consultants to navigate, manage, or attend to clinician distress? What happens when that clinician distress leads eventually to conflict between the consulting clinician and the palliative care team? Today our guests Sara Johnson, Yael Schenker, & Anne Kelly discuss these issues, including: A recent paper first authored by Yael asking if attending to clinician...
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In this week's podcast, we sit down with Drs. Sarguni Singh, Christian Furman, and Lynn Flint, three authors of the recent The authors dive into the challenges facing seriously ill older adults discharged to Skilled Nursing Facilities (SNFs), where fragmented care transitions, misaligned Medicare policies, and inadequate access to palliative care often result in burdensome hospitalizations and goal-discordant care. The discussion highlights key barriers in Medicare’s SNF and hospice benefits, including the inability to access concurrent hospice and SNF care, and explores...
info_outlineIn a recent episode of the GeriPal podcast, we explored whether the field of palliative care is in need of saving—and, if so, how to save it—with guests Ira Byock, Kristi Newport, and Brynn Bowman. Today, we shift focus to one actionable way to improve palliative care: through quality improvement (QI) collaboratives, registries, and benchmarking.
To guide this discussion, we’ve invited three leading experts in the field—Drs. Steve Pantilat, David Currow, and Arif Kamal—who bring invaluable experience as pioneers in developing QI collaboratives and registries. Together, they authored a recent paper in JPSM titled “The Case for Collaboration to Optimize Quality,” which underscores the importance of these efforts.
In this episode, Dr. David Currow shares lessons from Australia’s Palliative Care Outcomes Collaborative (PCOC), a national model for standardized data collection and benchmarking that has driven measurable improvements in palliative care. Meanwhile, Drs. Steve Pantilat and Arif Kamal reflect on the history of the Palliative Care Quality Collaborative (PCQC), a U.S.-based initiative formed in 2019 by merging the National Palliative Care Registry (NPCR), the Palliative Care Quality Network (PCQN), and the Global Palliative Care Quality Alliance (GPCQA). Although the PCQC had ambitious goals, it ultimately closed earlier this year. Together, the panelists unpack the reasons behind its closure and discuss the lessons future registries can take away from its challenges.
Throughout the conversation, we tackle some of the field’s biggest questions about registries and QI collaboratives: What data should be collected to create meaningful quality indicators? How can we minimize the administrative burden of data collection on clinicians? And how do we balance the risk of becoming narrowly focused “symptomatologists” with the need to maintain holistic, person-centered care? By addressing these questions, the panel highlights the immense potential of QI initiatives to enhance palliative care while remaining true to the field’s core mission: ensuring that patients and their families feel deeply cared for during life’s most vulnerable moments.