Prospective study of symptom control in 133 cases of palliative care inpatients in Shatin Hospital
Female; Hospitalization; Male; Adult; Prospective Studies; Aged; quality of life; 80 and over; Human; Palliative Care; Neoplasms/th [Therapy]; Middle Age; Health Care; Quality Assurance; Hong Kong/ep [Epidemiology]; Neoplasms/ep [Epidemiology]
We report a prospective study assessing the prevalence and severity of physical and nonphysical symptoms, and the benefits from treatment and intervention, in advanced cancer patients presenting to a local palliative care unit in Hong Kong. Patients were assessed by a modified version of the support team assessment schedule (STAS). The study highlighted some symptoms which needed better control, and also reinforced the team morale by demonstrating aspects where there was definite improvement. In general, the STAS was found to be practicable and acceptable by our patients and staff. The most important benefit gained from the study was the successful dissemination of the concept of audit and quality assurance throughout the unit, which is essential for continuous improvement in the future.
1999
Lo RS; Ding A; Chung TK; Woo J
Palliative Medicine
1999
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).
Journal Article
<a href="http://doi.org/10.1191/026921699677451150" target="_blank" rel="noreferrer">10.1191/026921699677451150</a>
Evaluation of a Continuous Quality Improvement Initiative for End-Of-Life Care for Older Noncancer Patients
Female; Humans; Male; Questionnaires; Aged; Total Quality Management; 80 and over; Hong Kong; Terminal Care/standards
OBJECTIVES: The burden of suffering among patients with end-stage chronic diseases may be greater than those of cancer patients, as a result of longer duration of illness trajectory and high prevalence of symptoms, yet they may be less likely to receive palliative care services. To improve the quality of care of these patients, we carried out a continuous quality improvement initiative among medical and nursing staff of a convalescent facility. DESIGN: Evaluation of a quality improvement initiative. SETTING: Nonacute institution in Hong Kong SAR, China. PARTICIPANTS: The participants were patients with advanced chronic diseases not opting for active treatment. INTERVENTION: The intervention was a continuous quality improvement process carried out over a 3-month period, consisting of service reengineering, provision of guidelines and educational material, and interactive sessions to achieve culture change among staff. Evaluation before and after the intervention included patient symptoms checklist and quality-of-life measures for patients; quality-of-life and cost-of-care index for family members; quality-of-life and carer burden for staff; and use of various health care services. RESULTS: There were 80 and 89 participants in the pre- and post-intervention phase. The initiative resulted in shorter duration of stay, fewer investigations, fewer transfers back to the affiliated acute care hospital, and more follow-up by the outreach team, with no significant difference in mortality after adjusting for age and comorbidity. Symptoms of pain and cough were reduced, while there was a trend toward more constipation but less dizziness. Family members' satisfaction improved. CONCLUSIONS: It is possible to improve quality-of-life care for elderly patients with end-stage chronic diseases by staff education, and culture and system change, not only without additional resources, but likely savings were achieved in terms of reduced use of health care resources.
Woo J; Cheng JO; Lee J; Lo R; Hui E; Lum CM; Or KH; Yeung F; Wong F; Mak B
Journal of the American Medical Directors Association
2011
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).
Journal Article
<a href="http://doi.org/10.1016/j.jamda.2010.02.011" target="_blank" rel="noreferrer noopener">10.1016/j.jamda.2010.02.011</a>