The Experience of Hospital Death: Assessing the Quality of Care at an Academic Medical Center

Elise Carey, Ann M. Dose, Katherine M. Humeniuk, Yichen C. Kuan, Ashley D. Hicks, Abigale L. Ottenberg, Jon C Tilburt, Barbara Koenig

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The quality of perimortem care received by patients who died at our hospitals was unknown. Objective: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents’ families. Design: Telephone survey that included established measures and investigator-developed content. Setting: Large, tertiary care center known for high-quality, cost-effective care. Participants: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year. Intervention: None. Measurements: Participant perceptions of the decedent’s care, including symptom management, personal care, communication, and care coordination. Results: Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents’ anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents’ illness (29%), and receiving contradictory or confusing information (33%). Conclusion: Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.

Original languageEnglish (US)
Pages (from-to)189-197
Number of pages9
JournalAmerican Journal of Hospice and Palliative Medicine
Volume35
Issue number2
DOIs
StatePublished - Feb 1 2018

Fingerprint

Quality of Health Care
Anxiety
Communication
Bandages
Spouses
Telephone
Tertiary Care Centers
Dyspnea
Patient Care
Research Personnel
Costs and Cost Analysis
Pain
Surveys and Questionnaires

Keywords

  • death
  • decedent
  • family caregivers
  • hospitals
  • quality of health care
  • terminal care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The Experience of Hospital Death : Assessing the Quality of Care at an Academic Medical Center. / Carey, Elise; Dose, Ann M.; Humeniuk, Katherine M.; Kuan, Yichen C.; Hicks, Ashley D.; Ottenberg, Abigale L.; Tilburt, Jon C; Koenig, Barbara.

In: American Journal of Hospice and Palliative Medicine, Vol. 35, No. 2, 01.02.2018, p. 189-197.

Research output: Contribution to journalArticle

Carey, Elise ; Dose, Ann M. ; Humeniuk, Katherine M. ; Kuan, Yichen C. ; Hicks, Ashley D. ; Ottenberg, Abigale L. ; Tilburt, Jon C ; Koenig, Barbara. / The Experience of Hospital Death : Assessing the Quality of Care at an Academic Medical Center. In: American Journal of Hospice and Palliative Medicine. 2018 ; Vol. 35, No. 2. pp. 189-197.
@article{5070bac725034207aff1f5c857aecba4,
title = "The Experience of Hospital Death: Assessing the Quality of Care at an Academic Medical Center",
abstract = "Background: The quality of perimortem care received by patients who died at our hospitals was unknown. Objective: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents’ families. Design: Telephone survey that included established measures and investigator-developed content. Setting: Large, tertiary care center known for high-quality, cost-effective care. Participants: Family members of 104 patients who died in-hospital (10{\%} of annual deaths) over the course of 1 year. Intervention: None. Measurements: Participant perceptions of the decedent’s care, including symptom management, personal care, communication, and care coordination. Results: Decedents were mostly male (64{\%}), white (96{\%}), married (73{\%}), and Christian (91{\%}). Most survey participants were spouses of the decedent (68{\%}); they were predominately white (98{\%}), female (70{\%}), and Christian (90{\%}) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73{\%}, 73{\%}, and 55{\%}, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87{\%}) and that sufficient help was available to assist with medications and dressing changes (97{\%}). Opportunities for improvement included management of decedents’ anxiety or sadness (29{\%}) and personal care (25{\%}), emotional support of the family (57{\%}), communication regarding decedents’ illness (29{\%}), and receiving contradictory or confusing information (33{\%}). Conclusion: Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.",
keywords = "death, decedent, family caregivers, hospitals, quality of health care, terminal care",
author = "Elise Carey and Dose, {Ann M.} and Humeniuk, {Katherine M.} and Kuan, {Yichen C.} and Hicks, {Ashley D.} and Ottenberg, {Abigale L.} and Tilburt, {Jon C} and Barbara Koenig",
year = "2018",
month = "2",
day = "1",
doi = "10.1177/1049909116689547",
language = "English (US)",
volume = "35",
pages = "189--197",
journal = "American Journal of Hospice and Palliative Medicine",
issn = "1049-9091",
publisher = "SAGE Publications Inc.",
number = "2",

}

TY - JOUR

T1 - The Experience of Hospital Death

T2 - Assessing the Quality of Care at an Academic Medical Center

AU - Carey, Elise

AU - Dose, Ann M.

AU - Humeniuk, Katherine M.

AU - Kuan, Yichen C.

AU - Hicks, Ashley D.

AU - Ottenberg, Abigale L.

AU - Tilburt, Jon C

AU - Koenig, Barbara

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: The quality of perimortem care received by patients who died at our hospitals was unknown. Objective: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents’ families. Design: Telephone survey that included established measures and investigator-developed content. Setting: Large, tertiary care center known for high-quality, cost-effective care. Participants: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year. Intervention: None. Measurements: Participant perceptions of the decedent’s care, including symptom management, personal care, communication, and care coordination. Results: Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents’ anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents’ illness (29%), and receiving contradictory or confusing information (33%). Conclusion: Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.

AB - Background: The quality of perimortem care received by patients who died at our hospitals was unknown. Objective: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents’ families. Design: Telephone survey that included established measures and investigator-developed content. Setting: Large, tertiary care center known for high-quality, cost-effective care. Participants: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year. Intervention: None. Measurements: Participant perceptions of the decedent’s care, including symptom management, personal care, communication, and care coordination. Results: Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents’ anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents’ illness (29%), and receiving contradictory or confusing information (33%). Conclusion: Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.

KW - death

KW - decedent

KW - family caregivers

KW - hospitals

KW - quality of health care

KW - terminal care

UR - http://www.scopus.com/inward/record.url?scp=85040318801&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040318801&partnerID=8YFLogxK

U2 - 10.1177/1049909116689547

DO - 10.1177/1049909116689547

M3 - Article

C2 - 28103711

AN - SCOPUS:85040318801

VL - 35

SP - 189

EP - 197

JO - American Journal of Hospice and Palliative Medicine

JF - American Journal of Hospice and Palliative Medicine

SN - 1049-9091

IS - 2

ER -