title: Feeling Heard and Understood: A Patient-Reported Quality Measure for the Inpatient Palliative Care Setting.
abstract: BACKGROUND
  As endorsed by the palliative care "Measuring What Matters" initiative, capturing patients' direct assessment of their care is essential for ongoing quality reporting and improvement. Fostering an environment where seriously ill patients feel heard and understood is of crucial importance to modern health care.
  
  
  OBJECTIVE
  To describe the development and performance of a self-report field measure for seriously ill patients to report how well they feel heard and understood in the hospital environment.
  
  
  METHODS
  As part of a larger ongoing cohort study of inpatient palliative care, we developed and administered the following point-of-care item: "Over the past two days, how much have you felt heard and understood by the doctors, nurses and hospital staff?" (completely, quite a bit, moderately, slightly, not at all). Participants completed the measure before and the day after palliative care consultation. For the postconsultation version, we changed the time frame from "past two days" to "today."
  
  
  RESULTS
  One hundred sixty patients with advanced cancer completed the preconsultation assessment, and 87% of them completed the postconsultation version. Responses encompassed full use of the ordinal scale, did not exhibit ceiling or floor effects, and showed improvement from preassessment to postassessment. The item was quick to administer and easy for patients to complete.
  
  
  CONCLUSIONS
  The "Heard & Understood" item is a promising self-report quality measure for the inpatient palliative care setting.
authors.affiliation: University of Rochester, Rochester, New York, USA. Electronic address: Robert_Gramling@URMC.Rochester.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Gramling
authors.affiliation: University of Rochester, Rochester, New York, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Stanek
authors.affiliation: University of Rochester, Rochester, New York, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Ladwig
authors.affiliation: University of Rochester, Rochester, New York, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gajary-Coots
authors.affiliation: University of California at San Francisco, San Francisco, California, USA.
authors.forename: Jenica
authors.initials: J
authors.lastname: Cimino
authors.affiliation: University of California at San Francisco, San Francisco, California, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Anderson
authors.affiliation: University of Rochester, Rochester, New York, USA.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Norton
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Aslakson
authors.forename: Katherine
authors.initials: K
authors.lastname: Ast
authors.forename: Ronit
authors.initials: R
authors.lastname: Elk
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Garner
authors.forename: Robert
authors.initials: R
authors.lastname: Gramling
authors.forename: Corita
authors.initials: C
authors.lastname: Grudzen
authors.forename: Arif H
authors.initials: AH
authors.lastname: Kamal
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Lamba
authors.forename: Thomas W
authors.initials: TW
authors.lastname: LeBlanc
authors.forename: Ramona L
authors.initials: RL
authors.lastname: Rhodes
authors.forename: Eric
authors.initials: E
authors.lastname: Roeland
authors.forename: Dena
authors.initials: D
authors.lastname: Schulman-Green
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Unroe
mesh_terms: D015331:Cohort Studies; D003142:Communication; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care / Q000379:methods*; D057566:Self Report; D014481:United States
keywords: Quality improvement; communication; palliative care; quality indicators; quality of care