Family-Driven Quality Improvement in Inpatient End-of-Life Care

Abstract

To enhance end-of-life care in a community hospital system, an interdisciplinary team designed and implemented a mail survey to obtain feedback from families of inpatients who died. The 855 completed surveys (a 31% response rate) demonstrate that bereaved families are willing to give feedback on care received from nurses and physicians and attention paid to the personal needs of patients and families. The team used families' feedback to shape quality improvement initiatives and focused on questions with comparatively lower scores: physician communication, physician compassion, and family understanding of what to expect as their loved one approached the end of life.

Intensive care patient and family satisfaction

“…Patient satisfaction with the perceived care quality has become an important measure during the care quality evaluation process and a recent outcome research focus (Davidson et al, 2007). Quality improvement processes must increasingly be centered on the healthcare consumer (Hodges et al, 2006). This shift becomes especially relevant in intensive care units (ICUs), where traditional desirable health status outcomes may not be attainable after a critical illness.…”

The Comfort Measures Order Set at a Tertiary Care Academic Hospital: Is There a Comparable Difference in End-of-Life Care Between Patients Dying in Acute Care When CMOS Is Utilized?

“…5 Briefly, the process was initiated with a comprehensive literature review that explored domains of quality dying by both patients and families. The search identified 1447 articles, of which 12 outlined 8 essential care domains by patients and families for the delivery of quality EOL care [14][15][16][17][18][19][20][21][22][23][24][25] : (1) effective pain and symptom management for the patient; (2) timely and clear communication with clinicians; (3) information to prepare the family for impending death of the loved one; (4) spirituality, dignity, and respect for the patient; (5) patient-centered decision-making prior to the loved one's death; (6) practical needs of the family; (7) supportive needs of the family; and (8) families' overall satisfaction with hospital staff and facilities.…”