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Something very special happens when the patient or family outcomes that the improvement team aims for are a prominent part of routine data collection. In the VITAS hospice system, patients are routinely asked about comfort, spiritual peace, and family relationships. This makes it possible to compare programs in different cities or to track the performance of one clinical team over time. Since the questions are appropriate to clinical issues, staff do not see recording them as requiring additional effort.
The Minimum Data Set now required by federal regulation of nursing facilities has similar features. Every few months, function and comfort are routinely recorded for every nursing home resident. In aggregate, facility performance over time on these measures is readily tracked.
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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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