Application of quality audit tools to evaluate care quality received by terminal cancer patients admitted to a palliative care unit.
OBJECTIVE
We aimed to evaluate the palliative care quality for terminal cancer patients as a reference for prospective service improvements.


METHODS
A prospective study was conducted to analyze the quality audit data collected from 1,476 samples in one medical center's palliative care unit. Lai's modified version of the support team assessment schedule was utilized for 2-year data collection, applying 17 categories of audit criteria rated on a scale of 0 to 4 (0-no symptoms, 4-significant symptoms). The quality audit criteria were scored weekly for 2 weeks following patient admission.


RESULTS
Average scores of quality audit criteria from admission to week 2 were 10.05, 8.85, and 8.49, respectively, with statistical differences noted weekly. Efficacy of palliative care was most evident 2 weeks after hospitalization. Factors with statistically significant differences between admission and week 1 included: pain control, constipation, vomiting, anorexia, other symptom control, patient anxiety, self awareness and preparation of patient for illness, self awareness and preparation of family for illness, and satisfaction of patient's spiritual belief and life philosophy. Factors with statistically significant differences between weeks 1 and 2 included: pain control, other symptom control, self awareness and preparation of family for illness, and satisfaction of patient's spiritual belief and life philosophy.


CONCLUSIONS
Patients in hospice care received adequate symptom relief. Total quality audit scores declined progressively over the 2 weeks following patient admission, indicating efficacy of palliative care quality.
Tsai
Li-Yun
LY
Department of Nursing, Mackay Memorial Hospital, No. 45 Minsheng Road, Danshui, 251 Taipei County, Taiwan, Republic of China. liyun@ms1.mmh.org.tw
Li
In-Fun
IF
Liu
Ching-Ping
CP
Su
Wen-Hao
WH
Change
Tse-Yun
TY
D000328:Adult; D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D010549:Personal Satisfaction; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*; D013624:Taiwan; D013727:Terminal Care / Q000592:standards*; D017749:Total Quality Management