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In 1997, the Promoting Excellence Program Office received 678 letters of intent. Despite the outpouring of interest and ideas, only a handful could receive funding to address end-of-life issues. In an effort to tap this energy and prompt rapid change, "National Workgroups" were created, composed of clinicians and researchers in specific niches of medicine, to extend palliative care to challenging domains and special populations of patients.
Beginning in June 1999, Promoting Excellence workgroups were chosen in areas indicating a readiness to address end-of-life care issues, to include: End-Stage Renal Disease, Critical Care, Pediatrics, ALS, Cost Accounting, Surgery, Huntington's Disease, and HIV/AIDS. An orientation packet describing workgroup form and function was developed that contained a description of expectations, roles, responsibilities, structure, and contract/budget procedures as well as tools to help workgroups maintain focus (such as a workgroup charter template). Chairpersons were selected by the NPO and membership (generally ranging from 15-30 per group except for the Critical Care Workgroup with 45 members) was jointly developed by the workgroup chairperson(s) and NPO staff to include key stakeholders such as members of professional associations, the field's thought leaders, and recognized clinician-researchers. The Promoting Excellence theory was that recommendations of such groups, acting in good faith on behalf of their professions and the public, would have a good chance of being widely and seriously discussed and in some cases, implemented nationwide. Workgroup recommendations and issue papers might provide policy-makers and health system planners with a road map for substantive change.
The national workgroups identified resources, gaps and products for the field and developed Research and Development Agendas and Recommendations to the Field summaries, generally within a two-year timeframe. Workgroup structure included support for an initial, mid-point and final face-to-face meeting along with intervening conference calls. Most but not all workgroups divided into subcommittees whose membership communicated via monthly conference calls between meetings. Some workgroups were managed internally and others were outsourced to professional or advocacy organizations. The workgroup project ended May 31, 2005.
Workgroup Model and Orientation Manual
Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families.