The Hospice friendly Hospitals Programme (HfH) commissioned this study to assess the quality of end-of-life care in acute and community hospitals from the perspectives of bereaved relatives. A major rationale for the study was to develop and test methodology to survey bereaved relatives' views of end-of-life care that covers the HfH Programme themes of Integrated Care, Communication, Patient Autonomy and Design & Dignity. Another driver was to inform the set-up of a Nationwide Audit of End-of-Life Care (McKeown et al., 2010).
The overall aim of the study was to assess the quality of end-of-life care in two acute and two community hospitals from the perspectives of bereaved relatives. Study subobjectives were to conduct a literature review to ascertain important ethical and methodological issues; to describe a census of deaths across study sites; to field test a survey instrument aimed evaluating the impact of the Hospice friendly Hospitals (HfH) Programme; to collect data about HfH Programme themes; and to establish if there were any differences in the pattern of results between acute and community hospitals.
The overall aim of the study was to assess the quality of end-of-life care in two acute and two community hospitals from the perspectives of bereaved relatives. Study subobjectives were to conduct a literature review to ascertain important ethical and methodological issues; to describe a census of deaths across study sites; to field test a survey instrument aimed evaluating the impact of the Hospice friendly Hospitals (HfH) Programme; to collect data about HfH Programme themes; and to establish if there were any differences in the pattern of results between acute and community hospitals.
- Conducting postal surveys of bereaved relatives is an acceptable form of end-of-life care research in Ireland, with 40% consenting to receive a questionnaire, and, of that number, an 83.1% response rate.
- Relatives of patients in community hospitals have a tendency to rate the quality of end-of-life care better than relatives of patients who died in acute hospitals.
- Research demonstrates that hospital staff should have have increased discussion with patients and families regarding type of room during the last hospital stay and at time of dying.
- Two thirds of respondents in the acute hospital group indicated that the patients' personal care needs were "always" taken care of well, as compared to 83.8% of respondents in the community hospital group.
- Findings suggest that healthcare professionals in acute hospitals may be better positioned to respond to the emotional and support needs of families than of dying patients.
- The overall satisfaction score for the community hospital group was higher than the score for the acute hospital group.
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- Copyright 2010 Hospice Friendly Hospitals, Royal College of Surgeons in Ireland, Institute of Leadership.
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