title: Family perceptions of quality of hospice care in the nursing home.
abstract: BACKGROUND
  Nursing homes (NHs) are increasingly the site of hospice care. High quality of care is dependent on successful NH-hospice collaboration.
  
  
  OBJECTIVE
  To examine bereaved family members' perceptions of NH-hospice collaborations in terms of what they believe went well or could have been improved.
  
  
  METHODS
  Focus groups were conducted with bereaved family members from five diverse geographic regions, and included participants from inner city and rural settings, with oversampling of African Americans.
  
  
  RESULTS
  A total of 28 participants (14.8% African American, mean age 61.4 years) identified three major aspects of collaboration as important to care delivery. First, most (67.9%) voiced concerns with knowing who (NH or hospice) is responsible for which aspects of patient care. Second, nearly half (42.9%) stated concern about information coordination between the NH and hospice. Finally, 67.9% of the participants mentioned the need for hospice to advocate for high-quality care rather than their having to directly do so on behalf of their family members.
  
  
  CONCLUSIONS
  The important concerns raised by bereaved family members about NH-hospice collaboration have been incorporated into the revised Family Evaluation of Hospice Care, a post-death survey used to evaluate quality of hospice care.
authors.affiliation: Brown University Providence, Rhode Island, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Hwang
authors.affiliation: Brown University Providence, Rhode Island, USA. Electronic address: jmteno76@mac.com.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Teno
authors.affiliation: Brown University Providence, Rhode Island, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Clark
authors.affiliation: Brown University Providence, Rhode Island, USA.
authors.forename: Renée
authors.initials: R
authors.lastname: Shield
authors.affiliation: Brown University Providence, Rhode Island, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Williams
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: David
authors.initials: D
authors.lastname: Casarett
authors.affiliation: National Hospice and Palliative Care Organization, Alexandria, Virginia, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Spence
mesh_terms: D001741:Black or African American / Q000523:psychology; D005190:Family / Q000208:ethnology / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D066275:Health Information Exchange; D017051:Hospice Care / Q000379:methods* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010344:Patient Advocacy / Q000523:psychology; D010465:Perception; D011787:Quality of Health Care
keywords: Hospice; family perception; nursing home; quality care