Determinants of care outcomes for patients who die in hospital in Ireland: a retrospective study.

Hdl Handle:
http://hdl.handle.net/10147/556457
Title:
Determinants of care outcomes for patients who die in hospital in Ireland: a retrospective study.
Authors:
McKeown, Kieran; Haase, Trutz; Pratschke, Jonathan; Twomey, Shelagh; Donovan, Helen; Engling, Feline
Citation:
Determinants of care outcomes for patients who die in hospital in Ireland: a retrospective study. 2015, 14:11 BMC Palliat Care
Publisher:
BioMed Central
Journal:
BMC palliative care
Issue Date:
18-Apr-2015
URI:
http://hdl.handle.net/10147/556457
DOI:
10.1186/s12904-015-0014-2
PubMed ID:
25927310
Abstract:
More people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008/9. The study was undertaken as part of the Irish Hospice Foundation's Hospice Friendly Hospitals Programme (2007-2012).; Outcomes of care were assessed by nurses, doctors and relatives who cared for the patient during the last week of life. Multi-level modelling was used to analyse how care outcomes were influenced by care inputs.; The sample of 999 patients represents 10% of acute hospital deaths and 29% of community hospital deaths in Ireland in 2008/9. Five care outcomes were assessed for each patient: symptom experience, symptom management, patient care, acceptability of the way patient died, family support. Care outcomes during the last week of life tended to be better when: the patient had cancer; admission to hospital was planned rather than emergency; death occurred in a single room or where privacy, dignity and environment of the ward was better; team meetings were held; there was good communication with patients and relatives; relatives were facilitated to stay overnight and were present at the time of death; nursing staff were experienced and had training in end-of-life care; the hospital had specific objectives for developing end-of-life care in its service plan.; The study shows significant differences in how care outcomes, including pain, were assessed by nurses, doctors and relatives. Care inputs operate in a mutually reinforcing manner to generate care outcomes which implies that improvements in one area are likely to have spill-over effects in others. Building on these findings, the Irish Hospice Foundation has developed an audit and review system to support quality improvement in all care settings where people die.
Item Type:
Article
Language:
en
Description:
More people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008/9. The study was undertaken as part of the Irish Hospice Foundation's Hospice Friendly Hospitals Programme (2007-2012). METHODS: Outcomes of care were assessed by nurses, doctors and relatives who cared for the patient during the last week of life. Multi-level modelling was used to analyse how care outcomes were influenced by care inputs. RESULTS: The sample of 999 patients represents 10% of acute hospital deaths and 29% of community hospital deaths in Ireland in 2008/9. Five care outcomes were assessed for each patient: symptom experience, symptom management, patient care, acceptability of the way patient died, family support. Care outcomes during the last week of life tended to be better when: the patient had cancer; admission to hospital was planned rather than emergency; death occurred in a single room or where privacy, dignity and environment of the ward was better; team meetings were held; there was good communication with patients and relatives; relatives were facilitated to stay overnight and were present at the time of death; nursing staff were experienced and had training in end-of-life care; the hospital had specific objectives for developing end-of-life care in its service plan. CONCLUSIONS: The study shows significant differences in how care outcomes, including pain, were assessed by nurses, doctors and relatives. Care inputs operate in a mutually reinforcing manner to generate care outcomes which implies that improvements in one area are likely to have spill-over effects in others. Building on these findings, the Irish Hospice Foundation has developed an audit and review system to support quality improvement in all care settings where people die.
Keywords:
INPATIENT; HOSPITAL; DEATH
ISSN:
1472-684X

Full metadata record

DC FieldValue Language
dc.contributor.authorMcKeown, Kieranen
dc.contributor.authorHaase, Trutzen
dc.contributor.authorPratschke, Jonathanen
dc.contributor.authorTwomey, Shelaghen
dc.contributor.authorDonovan, Helenen
dc.contributor.authorEngling, Felineen
dc.date.accessioned2015-06-05T12:48:58Zen
dc.date.available2015-06-05T12:48:58Zen
dc.date.issued2015-04-18en
dc.identifier.citationDeterminants of care outcomes for patients who die in hospital in Ireland: a retrospective study. 2015, 14:11 BMC Palliat Careen
dc.identifier.issn1472-684Xen
dc.identifier.pmid25927310en
dc.identifier.doi10.1186/s12904-015-0014-2en
dc.identifier.urihttp://hdl.handle.net/10147/556457en
dc.descriptionMore people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008/9. The study was undertaken as part of the Irish Hospice Foundation's Hospice Friendly Hospitals Programme (2007-2012). METHODS: Outcomes of care were assessed by nurses, doctors and relatives who cared for the patient during the last week of life. Multi-level modelling was used to analyse how care outcomes were influenced by care inputs. RESULTS: The sample of 999 patients represents 10% of acute hospital deaths and 29% of community hospital deaths in Ireland in 2008/9. Five care outcomes were assessed for each patient: symptom experience, symptom management, patient care, acceptability of the way patient died, family support. Care outcomes during the last week of life tended to be better when: the patient had cancer; admission to hospital was planned rather than emergency; death occurred in a single room or where privacy, dignity and environment of the ward was better; team meetings were held; there was good communication with patients and relatives; relatives were facilitated to stay overnight and were present at the time of death; nursing staff were experienced and had training in end-of-life care; the hospital had specific objectives for developing end-of-life care in its service plan. CONCLUSIONS: The study shows significant differences in how care outcomes, including pain, were assessed by nurses, doctors and relatives. Care inputs operate in a mutually reinforcing manner to generate care outcomes which implies that improvements in one area are likely to have spill-over effects in others. Building on these findings, the Irish Hospice Foundation has developed an audit and review system to support quality improvement in all care settings where people die.en
dc.description.abstractMore people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008/9. The study was undertaken as part of the Irish Hospice Foundation's Hospice Friendly Hospitals Programme (2007-2012).en
dc.description.abstractOutcomes of care were assessed by nurses, doctors and relatives who cared for the patient during the last week of life. Multi-level modelling was used to analyse how care outcomes were influenced by care inputs.en
dc.description.abstractThe sample of 999 patients represents 10% of acute hospital deaths and 29% of community hospital deaths in Ireland in 2008/9. Five care outcomes were assessed for each patient: symptom experience, symptom management, patient care, acceptability of the way patient died, family support. Care outcomes during the last week of life tended to be better when: the patient had cancer; admission to hospital was planned rather than emergency; death occurred in a single room or where privacy, dignity and environment of the ward was better; team meetings were held; there was good communication with patients and relatives; relatives were facilitated to stay overnight and were present at the time of death; nursing staff were experienced and had training in end-of-life care; the hospital had specific objectives for developing end-of-life care in its service plan.en
dc.description.abstractThe study shows significant differences in how care outcomes, including pain, were assessed by nurses, doctors and relatives. Care inputs operate in a mutually reinforcing manner to generate care outcomes which implies that improvements in one area are likely to have spill-over effects in others. Building on these findings, the Irish Hospice Foundation has developed an audit and review system to support quality improvement in all care settings where people die.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.rightsArchived with thanks to BMC palliative careen
dc.subjectINPATIENTen
dc.subjectHOSPITALen
dc.subjectDEATHen
dc.titleDeterminants of care outcomes for patients who die in hospital in Ireland: a retrospective study.en
dc.typeArticleen
dc.identifier.journalBMC palliative careen

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