Nomination Form

Objectives:  To recognize ongoing investment and achievement in improving access to end-of-life care by traditionally underserved populations.  The Advancing End-of-Life Care Access Award honors organizations that measurably increase access to end-of-life care through programs specifically designed for this purpose. 

Eligibility:  This award is open to NHPCO Provider Members.  The program to increase access must be fully implemented for more than 12 months and there must be data to demonstrate clear and concrete outcomes.  Further, the program should be based on a project plan that defines the target population, objectives, strategies, outcome measurement, and intended impact. 

Nomination Deadline: August 7, 2012

Selection Criteria: The following criteria will be used to determine the award recipient.

• Population and Barriers.  The targeted population and the barriers to access are well-defined.  There should be quantitative evidence the population was underserved prior to the program.  The evidence may be a community needs assessment, utilization data or other quantifiable factors.  Defining characteristics could include demographic characteristics (race, ethnicity, age, socioeconomic), disease-specific population, faith or religious beliefs, disability, etc.
• Objectives and Strategies.  The access program is based on a project plan that includes defined objectives for reducing or eliminating barriers to end-of-life care and specific strategies for achieving those objectives.
• Measureable Outcomes.  The project plan should define what outcomes will be measured and how the data to measure the outcomes will be gathered.   Nominees are expected to submit at least 12 months of data demonstrating the program’s efficacy.
• Meaningful Impact.  The outcomes demonstrate that the program significantly increased the type, scope, or range of services offered to and used by the targeted population.
• Enduring and Sustainable.  The program has been fully implemented for more than 12 months at the time of nomination and there are resources to continue it for the foreseeable future. 
• Shared and Promoted.  The nominee has proactively shared the program as a best practice with other providers.  Examples of sharing the program include presenting at conferences, writing an article, or using My.NHPCO to promote the program.
• Replicable.  The program can be implemented by other providers who have similar underserved populations in their service area.  Nominations must include a planning template others can use to implement the program.  See attached template guidance.

Review Process:  Applications will be reviewed and a winner of the award will be determined by the National Council of Hospice and Palliative Professionals Awards Committee.

Recognition:  The winning organization will receive the NHPCO Advancing End-of-Life Care Access Award during the upcoming annual Clinical Team Conference and will be recognized in the conference Learning Journal.  In addition, the winning organization will be invited to present their project/program at a future Clinical Team Conference. The winning organization’s program will be highlighted in NHPCO’s NewsLine. 

Award winners are expected to attend the Clinical Team Conference to accept the award.  Award winners are expected to cover their travel expenses to be at the conference.

Application Process: Complete the application that begins on the following page and submit two copies by e-mail to aduncan@nhpco.org.  One copy should be in a format that can be cut and pasted, preferably Microsoft Word.  The second copy should be a scanned version of the original that includes the signature of the senior officer of the member organization that implemented the program to increase access.

Supplementary Materials: Nominees are welcome to include supplementary materials such as fliers, PowerPoint presentations, or toolkits.  Note that the materials will need to be in a format that can be shared with the review panel electronically.

For Further Information Contact:

Andy Duncan, Director, Member Relations and Administrative Services 703-837-3145, aduncan@nhpco.org

Rowena Allen, Administrative Solutions Manager 703-647-5162, rallen@nhpco.org

National Hospice and Palliative Care Organization 1731 King Street Alexandria, VA 22314 Fax: 703-837-1233