Table 3.

Key domains and suggested quality metrics for a palliative approach to dialysis care

Domain	Potential Metrics
Elicitation of patient goals of care	Documentation of discussion of prognosis
	Frequency of documentation in medical orders, such as POLST, of patient goals of current care and preferences for life-sustaining treatments at the end of life
Physical, psychological, and spiritual symptoms	Frequency of documentation of symptoms by the dialysis care team
	Change in symptom scores over time
Caregiver support	Documentation of discussion and offering of peer support programs and relevant social service programs to caregivers
Patient and caregiver satisfaction	Frequency of documentation of satisfaction by the dialysis care team
	Change in satisfaction scores over time

POLST, Physician Orders for Life-Sustaining Treatment.