title: How well do we currently care for our dying patients in acute hospitals: the views of the bereaved relatives?
abstract: BACKGROUND
  The National Care of the Dying Audit-Hospitals (NCDAH) is used as a method to evaluate care for dying patients in England. An additional component to the 2013/2014 audit was the Local Survey of Bereaved Relatives Views using the 'Care Of the Dying Evaluation' (CODE) questionnaire.
  
  
  OBJECTIVE
  Within the context of the NCDAH audit, to evaluate quality of care provided to dying patients and their families in acute hospitals from the perspective of bereaved relatives.
  
  
  METHODS
  Postbereavement survey to bereaved relatives.
  
  
  METHODS
  For acute hospitals wishing to participate, consecutive 'expected' adult deaths occurring between 1 May and 30 June 2013 were identified and the CODE questionnaire was sent to the next-of-kin.
  
  
  RESULTS
  From 3414 eligible next-of-kin, 95 (2.8%) were excluded due to being involved in a complaint procedure and 1006 (29.5%) due to insufficient next-of-kin details. From the remaining 2313 potential participants, 858 returned a completed CODE questionnaire (37.1% response rate). Generally, symptoms were perceived to be well controlled with 769 (91%) participants reporting that either no pain was present or only there 'some of the time'. Unmet information needs, however, was a recognised area for improvement, for example, 230 (29%) reporting having a discussion about hydration would have been beneficial.
  
  
  CONCLUSIONS
  Adopting a postbereavement survey to NCDAH appears to be feasible, acceptable and a valuable addition. On the whole, the majority of participants reported good or excellent care. A small but significant minority, however, perceived poor quality of patient care with clear and timely communication urgently needed.
authors.affiliation: Marie Curie Palliative Care Institute Liverpool (MCPCIL), Cancer Research Centre, University of Liverpool, Liverpool, UK.
authors.forename: Catriona Rachel
authors.initials: CR
authors.lastname: Mayland
authors.affiliation: Marie Curie Palliative Care Institute Liverpool (MCPCIL), Cancer Research Centre, University of Liverpool, Liverpool, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Mulholland
authors.affiliation: Marie Curie Palliative Care Institute Liverpool (MCPCIL), Cancer Research Centre, University of Liverpool, Liverpool, UK.
authors.forename: Maureen
authors.initials: M
authors.lastname: Gambles
authors.affiliation: Marie Curie Palliative Care Institute Liverpool (MCPCIL), Cancer Research Centre, University of Liverpool, Liverpool, UK.
authors.forename: John
authors.initials: J
authors.lastname: Ellershaw
authors.affiliation: Clinical Effectiveness and Evaluation Unit, Royal College of Physicians, London, UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care; D013222:State Medicine; D011795:Surveys and Questionnaires; D019452:Terminally Ill; D055815:Young Adult
keywords: Service evaluation; Terminal care; post-bereavement survey; proxy; quality of healthcare