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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Patrick Coll, MD1, Rhonda L. Johnson, RN, BSN2, Elizabeth S. Micholovich, MPA2, Nancy Verzier, MSN, RN, CPHQ2, Sarah Cohen2, and James Duffy, MB ChB2. (1) Department of Family Medicine, Center on Aging/ Clinical Coordinator, The University of Connecticut Health Center/ Qualidigm®, 100 Roscommon Drive, Middletown, CT 06457, (860)679-4548, rjohnson@qualidigm.org, (2) Quality Improvement Services, Qualidigm®, 100 Roscommon Drive, Middletown, CT 06457
Concerns have been raised that end-of-life (EOL) care and pain management issues are not adequately addressed for hospitalized patients at risk of dying. In early 2000, the Connecticut (CT) Coalition to Improve EOL Care contracted with Qualidigm® (the CT Peer Review Organization) to conduct a quality improvement project aimed at improving the care of seriously ill patients at risk of dying in CT hospitals.
This project evaluates both the process and outcome of care related to end-of-life care and pain management. The target patient population includes patients 18 years of age and older who are admitted to the hospital with a primary diagnosis of cancer or who are admitted to the intensive care unit during their hospitalization.
Nine acute care hospitals are participating in the project. The measurement tools for this project are pre and post-intervention medical record abstraction tools and patient and family satisfaction surveys. Each participating hospital selected and implemented at least one intervention to improve end-of-life care and one intervention to improve pain assessment and management. Pre-intervention medical record abstraction was conducted on 370 patient medical records. The mean age of these patients was 67 years. The inpatient death rate for this group, 16.5% (61 deaths) which is higher than the state inpatient death rate of 3%.
The baseline data indicates that areas for improvement include documentation of pain assessment after analgesic administration and documentation of physicians’ discussions with patients/families about prognosis, advanced directives, spiritual needs, and bereavement issues. The study concludes on May 31, 2002.
Learning Objectives:
Keywords: End-of-Life Care, Quality Improvement
Presenting author's disclosure statement: