title: Quality of Care and Satisfaction With Care on Palliative Care Units.
abstract: BACKGROUND
  There is little research on quality of care specific to palliative care units (PCUs).
  
  
  OBJECTIVE
  To delineate important aspects of satisfaction with care and quality of care on a PCU, as described by inpatients, family caregivers, and health care professionals.
  
  
  METHODS
  Qualitative interviews and focus groups were conducted across four Toronto PCUs, with a total of 46 patient/caregiver interviews and eight staff focus groups. Interviews and focus groups were semistructured to elicit comments about satisfaction with care and quality of care for inpatients and families on a PCU. Data were analyzed using a grounded theory method, with an inductive, constant comparison approach to identify themes, and were coded to saturation.
  
  
  RESULTS
  Key elements of quality care and patient satisfaction on a PCU were grouped into six domains: 1) interprofessional team: a team of experts comprising multiple disciplines functioning as a unit; 2) communication: developing rapport, addressing expectations, providing information, listening actively, and facilitating end-of-life discussions; 3) attentive, personalized care: anticipatory and responsive compassionate care with tailored management of physical and nonphysical symptoms; 4) family-centered: support of patients and caregivers within a family; 5) accessible and consistent: appropriate resources and adequate staff to provide consistent care; and 6) supportive setting: a bright noninstitutionalized setting allowing both privacy and socialization.
  
  
  CONCLUSIONS
  The elements identified support the delivery of quality care. They may act as a guide for those planning to develop PCUs and form the basis for measures of satisfaction with care.
authors.affiliation: Department of Supportive Care, University Health Network, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Wentlandt
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychosocial Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Dori
authors.initials: D
authors.lastname: Seccareccia
authors.affiliation: Department of Supportive Care, University Health Network, Toronto, Ontario, Canada.
authors.forename: Nanor
authors.initials: N
authors.lastname: Kevork
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto East General Hospital, Toronto, Ontario, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Workentin
authors.affiliation: Department of Cancer Services Planning and Performance, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Blacker
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Baycrest, Toronto, Ontario, Canada.
authors.forename: Daphna
authors.initials: D
authors.lastname: Grossman
authors.affiliation: Department of Supportive Care, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology & Hematology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Campbell Family Cancer Research Institute, Ontario Cancer Institute, Toronto, Ontario, Canada. Electronic address: camilla.zimmermann@uhn.on.ca.
authors.forename: Camilla
authors.initials: C
authors.lastname: Zimmermann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010166:Palliative Care / Q000379:methods* / Q000523:psychology*; D010348:Patient Care Team; D017060:Patient Satisfaction; D057285:Precision Medicine / Q000379:methods / Q000523:psychology; D036301:Qualitative Research; D011787:Quality of Health Care
keywords: Palliative care unit; caregiver; focus group; inpatient; qualitative; quality of care; satisfaction with care