Best practices in hospital end-of-life care.
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.
Coll
Patrick P
PP
University of Connecticut Health Center, Center on Aging, Farmington, Qualidigm, Middletown, USA.
Duffy
James D
JD
Micholovich
Elizabeth
E
Cohen
Sarah
S
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*