Improving Care for the End of Life, Online Edition The Palliative Care Policy Center

Sourcebook : 6.1 Promote Patient and Caregiver Confidence in the Care System : 6.1.1 Case Study - Hospice of Michigan

With its Breakthrough Series project, "Caregivers as Colleagues," the Hospice of Michigan aimed to improve patient and family confidence. More than 20 teams statewide care for the Hospice of Michigan's daily census of more than 900 patients. For its Plan-Do-Study-Act cycles, the group aimed to decrease caregiver anxiety and increase caregiver confidence. To measure the effects of changes, the team:

The team tested each intervention with about 10 patients. Unplanned Events by Intervention Tried, Hospice of Michigan, Southfield, MI. During the first Plan-Do-Study-Act cycles, family caregivers were given a pager, which hospice staff could use to contact caregivers who were not present in the home during a hospice visit. More important, carrying the pagers allowed caregivers to feel that patients or family members could easily reach them. During the second cycle, participating families were asked to pay for the pager, although some were given financial assistance.

Other changes tested were:

The team learned several things during its study cycles. For instance, when its changes were successful, the team found it easy to spread the word and encourage others to try those changes. The team also learned that health care providers cannot always assume to know what would be best for caregivers and instead must ask about caregivers' needs. The group was surprised to find that caregivers do not necessarily want or need more communication with health care providers. The team found that caregivers did want information about hospice visits - but only when calls came at the "right time." One way to resolve this was to have the case manager set up a communication schedule with the family caregiver.

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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.

For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].

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