Innovations in End-of-Life Care
an international journal of leaders in end-of-life care

The purpose of Innovations in End-of-Life Care is to improve the quality of care provided to patients near the end of life and to their families, through the dissemination and critical examination of innovative practices being implemented throughout the world. An innovation can be any medical or non-medical activity organized by health care institutions or community agencies to benefit persons in the endstage of illness and their families. The goal of such innovations should be to deliver more humane, more effective, more comprehensive, and/or more coordinated care, so that patients will experience enhanced comfort, higher physical functioning, and a greater sense of well-being.

The journal has focused on improvements in a variety of clinical settings, including hospitals, nursing homes, home care agencies, hospices, primary care offices, managed care organizations and integrated delivery systems. Topics range from pain and symptom management, to advance care planning, improved doctor-patient communication, respite care, bereavement, spirituality, the role of the arts in end-of-life care, and ways to enhance end-of-life care for patients and families from diverse cultural backgrounds. From January 1999 through September 2003, the journal published a broad range of types of innovations, from those that are primarily clinical in nature, such as algorithms for better cancer pain and symptom management to those that involve administrative redesign, such as the creation of an inpatient dementia unit where hospital routines are calibrated to minimize stress for patients and families. The journal is now archived at this site and remains fully and freely accessible.

By the term "innovations," the journal means to include practices that are new as well as practices that have been ongoing for some time in one or more regions of the world, but which are not yet well known or adopted in other regions. By publishing examples drawn from across the globe, the journal aims to speed the rate of innovation; international perspectives are also important for critiquing cultural and national assumptions about what is and is not possible and appropriate in end-of-life care. Therefore, each issue of the journal includes commentary representing a diverse range of views on the ethical and cultural issues related to the problems each featured innovation has been designed to address. Special tools the innovators have used, such as new clinical protocols, medical forms, visual aids, or data collection instruments are posted and available for downloading by readers. [See Useful Tools page, or the Resources and Tools page of each thematic issue.]

The primary focus of the journal is on identifying effective and humane ways that health care institutions are providing care to dying patients and their families, with a special emphasis on the administrative processes and organizational steps that were necessary for initiating and maintaining these improvements. While the focus is centered on the behavior of health care institutions and their leaders, the journal also has welcomed descriptions of innovations being conducted by community agencies or volunteer civic groups that have developed promising ways of enhancing the quality of life of people with endstage, chronic, degenerative conditions or other terminal illnesses.