Americans diagnosed with serious illnesses tend to have significantly poorer quality of life due to limited access to reliable palliative and end-of-life care. Individuals living with these conditions continue to experience health care that does not meet their needs, experience undue suffering, require increased care visits, and have limited or…

The author discusses an assessment of the Robert Wood Johnson Foundation's work over a 20-year period to improve end-of-life care in America. The case illustrates the evolution of the strategy from one focused on a multiyear randomized control trial of a series of hospital-based interventions that produced findings of "no effects" into several…