Department of Medicine

University of Pittsburgh

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The Coalition for Quality at the End of Life (CQEL)

CQEL is made up of leading health systems, providers, insurers, citizen groups, government agencies, and philanthropic, faith-based, and other organizations concerned about the quality of care that is available to seriously ill and dying people and their families in western Pennsylvania.


CQEL's mission is to improve end-of-life care in the region by identifying and collaborating with key stakeholder groups. CQEL works to achieve its mission by engaging the community to build demand for better end-of-life care, building capacity among local health care institutions for the delivery of skilled and compassionate care, focusing attention on the regulatory and financial barriers to quality end-of-life care, and promulgating appropriate standards and measures.

Steering Committee

Committee Members: Robert Arnold, Judy Black, and Nancy Zionts

CQEL is administered by the Jewish Healthcare Foundation as of July 1, 2010.

Contact: Nancy Zionts at or 412-594-2559.

Organizational Members

Work Groups

In 2006, the CQEL identified and formed working groups around the following five priorities for action, drawn from recommendations of the Pennsylvania Task Force for Quality at the End of Life. These are included in the report Improving End-of-Life Experiences for Pennsylvanians. Click here for links to the report and publicity.

  1. Demonstration Projects
  2. Documenting Treatment Preferences
  3. Engagement of Underserved Communities
  4. Professional Education, Accreditation, and Licensing
  5. Public Awareness/Education Campaign

CQEL Work Groups


Demonstration Projects: Work with agencies such as the Departments of Health, Health Care Reform, Public Welfare, Aging, and the PA Health Care Cost Containment Council (PHC4), along with CMS, to design and/or implement demonstration projects aimed at (1) improving quality at the end of life and (2) studying the effect of risk-adjusted payments to Medicare and Medicaid managed care plans for patients with life-limiting, eventually fatal chronic illnesses, in an effort to encourage continuity across time and healthcare delivery settings, including home-based care.


Documenting Treatment Preferences: Encourage the Department of Health, the state legislature, and accrediting bodies such as JCAHO and CHAP to adopt a standardized tool for documenting people's wishes, such as the POLST (Physician Orders for Life-Sustaining Treatment), to be used statewide and be transferable following patients to all care settings to improve quality of care across settings. Work to develop and implement a pilot for implementation in the region.


Engagement of Underserved Communities: Engage underserved communities, such as minorities and people with disabilities, in discussions and workshops that assess their needs and involve community members in setting priorities for improvement of end-of-life care.


Professional Education, Accreditation, and Licensing: Pursue the following strategies for improving palliative and end-of-life care education:

  • Advocate for the utilization of existing structures and systems to ensure that health care professionals who provide care in any setting, as well as those who regulate institutions, will adopt and enforce standards for education. (For example, state professional licensing boards should require that candidates demonstrate evidence of training in palliative care/core end-of-life domains; agencies that regulate long-term care facilities should require evidence of staff training in end-of-life care; state surveyors of long-term care facilities should receive necessary training in end-of-life care.)
  • Work with accrediting bodies to require educational institutions to incorporate core palliative care educational domains in their curricula.
  • Partner with professional organizations (e.g., American Medical Association and the National Association of Social Work) to design/sponsor train-the-trainer programs for faculty responsible for end-of-life instruction and continuing education in core end-of-life domains at local, regional, and state meetings.

Public Awareness/Education Campaign: Work with various media outlets and private and public partners (i.e., the governor's office and Departments of Health, Health Care Reform, and Aging) to implement the regional arm of a statewide public awareness/education campaign. The intention of this campaign is to improve Pennsylvanians' access to palliative care and end-of-life services by helping them become more informed about palliative care and be proactive consumers of quality health care services. This campaign would be characterized by the following:

  • Include a Web-based statewide clearinghouse for palliative care for health care professionals and consumers.
  • Be informed by the life situation and palliative care needs of a variety of groups and individuals, including the elderly, people with disabilities, and children and their families.
  • Involve individuals from the community, such as hospice and palliative care educators, spokespersons, outreach workers, and liaisons.
  • Encourage the governor's office to mandate that the Departments of Health and Aging and other appropriate state agencies jointly prepare a "State of End-of-Life Care Report" every 2 years to describe ongoing state initiatives and to track changes over time.

CQEL Contact Information

Jewish Healthcare Foundation
Center City Tower, Suite 2400
650 Smithfield Street
Pittsburgh, PA 15222
Phone: 412-594-2559
Fax: 412-232-6240