title: Best practices in hospital end-of-life care.
abstract: The Connecticut Best Practices in End-of-Life Care project was initiated in response to the concern that Connecticut hospitals were not meeting the needs of dying patients. The records of 420 patients with a diagnosis of cancer or with an admission to an intensive-care unit were reviewed for the period 04/01/2000 to 03/31/2001. Utilizing a chart extraction tool, measures of "best practice" were developed as a means of assessing the quality of end-of-life care provided to the patient cohort. Some of the findings on the "best practice" indicators were as follows: 65 (15.3%) of the patient cohort died during their hospital stay. Three hundred forty (81.3%) had a pain assessment on admission. Three hundred eighty-six (92.6%) had a pain assessment on at least one occasion during their hospital stay. Two hundred forty-two of 397 (61%) patients who received an analgesic medication had their pain reassessed within fours hours of receiving the medication. One hundred ninty-five (46.4%) patients had their prognosis discussed with them. Eighteen patients (< 5%) were referred to hospice. Connecticut hospitals are doing well in assessing patient pain. However, they are doing poorly in discussing prognosis with sick patients and referring them to hospice.
authors.affiliation: University of Connecticut Health Center, Center on Aging, Farmington, Qualidigm, Middletown, USA.
authors.forename: Patrick P
authors.initials: PP
authors.lastname: Coll
authors.forename: James D
authors.initials: JD
authors.lastname: Duffy
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Micholovich
authors.forename: Sarah
authors.initials: S
authors.lastname: Cohen
mesh_terms: D019985:Benchmarking; D003237:Connecticut; D005260:Female; D006301:Health Services Needs and Demand; D006738:Hospices / Q000592:standards; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010351:Patient Discharge; D015397:Program Evaluation; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation; D013727:Terminal Care / Q000592:standards*