An Observational Study to Explore the Feasibility of Assessing Bereaved Relatives’ Experiences Before and After a Quality Improvement Project to Improve Care of Dying Medical Inpatients

Clark, Katherine; Willis, Abbey; Byfieldt, Naomi

doi:10.1177/1049909115625280

Cited by 5 publications

(5 citation statements)

References 31 publications

(25 reference statements)

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“…Families spend long days and many hours with relatives who are seriously unwell or dying in acute hospitals. Similar to other studies [71, 99, 106], some relatives in this study, through free text comments, advocated the importance of having appropriate family facilities on acute hospital wards, providing privacy to meet with their family members and healthcare staff. The importance of enhancing the environment to promote dignity, privacy and therefore improve the care experience for patients and their relatives through the development of family rooms is reported elsewhere [41, 107–111].…”

Section: Discussionsupporting

confidence: 65%

“…Several aspects of the hospital’s physical environment has been identified by patients, families and healthcare staff as being important in the provision of good EoLC, including the levels of privacy, care in a single occupancy room, hygiene, atmosphere and noise levels and family facilities [98–104]. Several researchers [100, 105, 106] have indicated that care for the dying person in multiple occupancy rooms was deemed inappropriate due to the noise level and the busy atmosphere. McKeown et al [98] found that care outcomes were perceived as better when care was provided in a single occupancy room.…”

Section: Discussionmentioning

confidence: 99%

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Dying in acute hospitals: voices of bereaved relatives

Coimín

Prizeman

Korn³

et al. 2019

BMC Palliat Care

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BackgroundInternationally there is an increasing concern about the quality of end-of-life care (EoLC) provided in acute hospitals. More people are cared for at end of life and die in acute hospitals than in any other healthcare setting. This paper reports the views of bereaved relatives on the experience of care they and the person that died received during their last admission in two university adult acute tertiary hospitals.MethodsRelatives of patients who died were invited to participate in a post-bereavement postal survey. An adapted version of VOICES (Views of Informal Carers - Evaluation of Services) questionnaire was used. VOICES MaJam has 36 closed questions and four open-ended questions. Data were gathered in three waves and analysed using SPSS and NVivo. 356 respondents completed the survey (46% response rate).ResultsThe majority of respondents (87%: n = 303) rated the quality of care as outstanding, excellent or good during the last admission to hospital. The quality of care by nurses, doctors and other staff was highly rated. Overall, care needs were well met; however, findings identified areas of care which could be improved, including communication and the provision of emotional and spiritual support. In addition, relatives strongly endorsed the provision of EoLC in single occupancy rooms, the availability of family rooms on acute hospital wards and the provision of bereavement support.ConclusionsThis research provides a powerful snapshot in time into what works well and what could be improved in EoLC in acute hospitals. Findings are reported under several themes, including the overall quality of care, meeting care needs, communication, the hospital environment and support for relatives. Results indicate that improvements can be made that build on existing good practice that will enhance the experience of care for dying persons and their relatives. The study adds insights in relation to relative’s priorities for EoLC in acute hospitals and can advance care providers’, policy makers’ and educationalists’ priorities for service improvement.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Dying in acute hospitals: voices of bereaved relatives

Coimín

Prizeman

Korn³

et al. 2019

BMC Palliat Care

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“…Concern has been expressed about surveying this population, however other studies have noted the benefits [ 55 , 56 ]. Bereaved relatives in our study shared detailed moving insights into their experiences of EoLC.…”

Section: Discussionmentioning

confidence: 99%

Voices that matter: end-of-life care in two acute hospitals from the perspective of bereaved relatives

et al. 2018

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BackgroundEnd-of-life care (EoLC) is an experience that touches the lives of everyone. Dying in an acute hospital is a common occurrence in developed countries across the world. Previous studies have shown that there is wide variation in EoLC and at times is experienced as being of poor quality. Assessing and measuring the quality of care provided is a key component of all healthcare systems. This paper reports on the qualitative analysis of open-ended free text questions that were asked as part of a post-bereavement survey conducted in two adult acute hospitals in Ireland.MethodsThis was a quantitative descriptive post-bereavement postal survey, gathering data retrospectively from relatives or friends of patients who died, utilising an adapted version of the VOICES (Views of Informal Carers - Evaluation of Services) questionnaire. VOICES MaJam has 29 core questions, seven questions requesting personal demographic information and four open-ended questions gathering descriptive data about the care experience during the patient’s last admission to hospital. A total of 356 valid questionnaires were returned. Qualitative data were managed, coded and analysed with NVivo 10, using a template analysis framework approach.ResultsThree quarters (75%: n = 268) responded to at least one of the open-ended questions. Several key themes emerged, indicating areas that require particular attention in EoLC. Two themes relate to how care needs are met and how the hospital environment has a critical influence on EoLC experiences. The remaining three themes relate more to the interpersonal context including whether patients are treated with dignity and respect, the psychological, emotional and spiritual needs of patients and their family members and communication.ConclusionsAcute hospitals need to ensure that patients and their relatives receive high quality EoLC. Seeking the views of bereaved relatives should be considered by all hospitals and healthcare settings to ascertain the quality of care at end of life. This study contributes to our understanding and knowledge of what good EoLC looks like and where care can be improved, thus enabling hospitals to direct and inform quality improvement.

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“…Three free text open-ended questions were included in the section titled ‘other comments’ based on the experience of previous research and other survey instruments, which have reported that the inclusion of open-ended questions facilitated and provided rich insights into the quality of care at end of life from respondents for the purposes of quality improvement [ 2 , 3 , 72 ].…”

Section: Resultsmentioning

confidence: 99%

Dying, death and bereavement: developing a national survey of bereaved relatives

et al. 2023

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Background Assessing and measuring the experience and quality of care provided is central to the improvement of care delivery of all healthcare systems. This paper reports on the development of a survey instrument to capture the experiences of care at end of life from the perspective of bereaved relatives in the Republic of Ireland. Methods A multi-method, multi-stakeholder, sequential approach was adopted for this study. Items for inclusion in the survey instrument bank were identified through (1) a feasibility study and scoping literature review, (2) expert panel programme board review, (3) focus groups and (4) gap analysis. The following steps were undertaken to prioritise the items for inclusion in the final survey instrument: (1) a Delphi study (2) technical expert panel review (3) cognitive interviews with bereaved relatives and an (4) expert panel programme board review. Results Following an iterative process with key stakeholders, a survey instrument was developed with sections focusing on the provision of care at home, in the last nursing home / residential care facility, hospice and hospital, as well as care experience in the last 2 days of life, the relative’s experiences of care and support, the circumstances of care surrounding death and demographic information. In total, a bank of 123 questions were prioritised to be included in the National End of Life Survey instrument. Conclusion The survey will provide a standardised national approach to capturing the experience of care of those who have died, from the perspective of bereaved relatives in the Republic of Ireland. This will allow health service providers, policy makers and regulators to gather important insights into the experiences of care at end of life and will help fulfil the requirement of healthcare services to ensure they are providing high-quality care.

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An Observational Study to Explore the Feasibility of Assessing Bereaved Relatives’ Experiences Before and After a Quality Improvement Project to Improve Care of Dying Medical Inpatients

Cited by 5 publications

References 31 publications

Dying in acute hospitals: voices of bereaved relatives

Dying in acute hospitals: voices of bereaved relatives

Voices that matter: end-of-life care in two acute hospitals from the perspective of bereaved relatives

Dying, death and bereavement: developing a national survey of bereaved relatives

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