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Text
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URL Address
<a href="http://doi.org/10.1136/qshc.2005.017707" target="_blank" rel="noreferrer">http://doi.org/10.1136/qshc.2005.017707</a>
Dublin Core
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Title
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Improving comfort and communication in the ICU: a practical new tool for palliative care performance measurement and feedback
Publisher
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Quality & Safety in Health Care
Date
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2006
Subject
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Humans; United States; Pain Measurement; Professional-Family Relations; Cooperative Behavior; Communication; Pilot Projects; Program Development; Patient Satisfaction; Spirituality; Hospitals; Proxy; Feedback; decision making; Health Care; Quality Assurance; Health Care/organization & administration; Quality Indicators; Palliative Care/psychology/standards; Intensive Care Units/standards; Critical Care/psychology/standards; Voluntary/organization & administration/standards
Creator
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Nelson JE; Mulkerin CM; Adams LL; Pronovost PJ
Description
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OBJECTIVE: To develop a practical set of measures for routine monitoring, performance feedback, and improvement in the quality of palliative care in the intensive care unit (ICU). DESIGN: Use of an interdisciplinary iterative process to create a prototype "bundle" of indicators within previously established domains of ICU palliative care quality; operationalization of indicators as specified measures; and pilot implementation to evaluate feasibility and baseline ICU performance. SETTING: The national Transformation of the Intensive Care Unit program developed in the United States by VHA Inc. PATIENTS: Critically ill patients in ICUs for 1, > 3, and > 5 days. MEASUREMENTS AND MAIN RESULTS: Palliative care processes including identification of patient preferences and decision making surrogates, communication between clinicians and patients/families, social and spiritual support, and pain assessment and management, as documented in medical records. Application is triggered by specified lengths of ICU stay. Pilot testing in 19 ICUs (review of > 100 patients' records) documented feasibility, while revealing opportunities for quality improvement in clinician-patient/family communication and other key components of ICU palliative care. CONCLUSIONS: The new bundle of measures is a prototype for routine measurement of the quality of palliative care in the ICU. Further investigation is needed to confirm associations between measured processes and outcomes of importance to patients and families, as well as other aspects of validity.
2006
Identifier
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<a href="http://doi.org/10.1136/qshc.2005.017707" target="_blank" rel="noreferrer">10.1136/qshc.2005.017707</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2006
Adams LL
Backlog
Communication
Cooperative Behavior
Critical Care/psychology/standards
Decision Making
Feedback
Health Care
Health Care/organization & administration
Hospitals
Humans
Intensive Care Units/standards
Journal Article
Mulkerin CM
Nelson JE
Pain Measurement
Palliative Care/psychology/standards
Patient Satisfaction
Pilot Projects
Professional-family Relations
Program Development
Pronovost PJ
Proxy
Quality & Safety in Health Care
Quality Assurance
Quality Indicators
Spirituality
United States
Voluntary/organization & administration/standards