Improving quality in hospital end-of-life care: honest communication, compassion and empathy
BACKGROUND: With over half of expected deaths occurring in acute hospitals, and a workforce not trained to care for them, good quality end-of-life care in these settings is hard to achieve. The National Consensus Statement on Essential Elements for Safe and High-Quality End-of-Life Care has been tra...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567943/ https://www.ncbi.nlm.nih.gov/pubmed/31259290 http://dx.doi.org/10.1136/bmjoq-2019-000669 |
_version_ | 1783427185307025408 |
---|---|
author | Rawlings, Deb Devery, Kim Poole, Naomi |
author_facet | Rawlings, Deb Devery, Kim Poole, Naomi |
author_sort | Rawlings, Deb |
collection | PubMed |
description | BACKGROUND: With over half of expected deaths occurring in acute hospitals, and a workforce not trained to care for them, good quality end-of-life care in these settings is hard to achieve. The National Consensus Statement on Essential Elements for Safe and High-Quality End-of-Life Care has been translated into e-learning modules by the End of Life Essentials project, and this study aims to demonstrate how clinicians interpret the Consensus Statement in their day-to-day practice by answering the question at the end of each module: ‘Tomorrow, the one thing I can change to more appropriately provide end-of-life care is…’ METHODS: The modules were developed by a palliative care educator with the support of a peer review group and were piloted with 35 health professionals. Pre-post module evaluation data were collected and during a 10-month period from 2016 to 2017 a total of 5181 individuals registered for the project accessing one or more of the six modules. The data from 3201 free-text responses to the post hoc practice change question have been analysed, and themes generated. FINDINGS: Five themes are derived from the data: communication, emotional insight, professional mindset, person-centred care and professional practice. CONCLUSION: Learners who have completed End of Life Essentials have shared the ways they state they can change their practice tomorrow which may well be appreciated as a clinical response to the work by the Australian Commission on Safety and Quality in Health Care in leading and coordinating national improvements in quality and safety in healthcare in Australia. While intent cannot guarantee practice change, theory on intention—behaviour relations indicate that intentions have a strong association with behaviour. This indicates that the modules have the ability to influence end-of-life care in acute hospitals. |
format | Online Article Text |
id | pubmed-6567943 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65679432019-06-28 Improving quality in hospital end-of-life care: honest communication, compassion and empathy Rawlings, Deb Devery, Kim Poole, Naomi BMJ Open Qual Original Article BACKGROUND: With over half of expected deaths occurring in acute hospitals, and a workforce not trained to care for them, good quality end-of-life care in these settings is hard to achieve. The National Consensus Statement on Essential Elements for Safe and High-Quality End-of-Life Care has been translated into e-learning modules by the End of Life Essentials project, and this study aims to demonstrate how clinicians interpret the Consensus Statement in their day-to-day practice by answering the question at the end of each module: ‘Tomorrow, the one thing I can change to more appropriately provide end-of-life care is…’ METHODS: The modules were developed by a palliative care educator with the support of a peer review group and were piloted with 35 health professionals. Pre-post module evaluation data were collected and during a 10-month period from 2016 to 2017 a total of 5181 individuals registered for the project accessing one or more of the six modules. The data from 3201 free-text responses to the post hoc practice change question have been analysed, and themes generated. FINDINGS: Five themes are derived from the data: communication, emotional insight, professional mindset, person-centred care and professional practice. CONCLUSION: Learners who have completed End of Life Essentials have shared the ways they state they can change their practice tomorrow which may well be appreciated as a clinical response to the work by the Australian Commission on Safety and Quality in Health Care in leading and coordinating national improvements in quality and safety in healthcare in Australia. While intent cannot guarantee practice change, theory on intention—behaviour relations indicate that intentions have a strong association with behaviour. This indicates that the modules have the ability to influence end-of-life care in acute hospitals. BMJ Publishing Group 2019-05-31 /pmc/articles/PMC6567943/ /pubmed/31259290 http://dx.doi.org/10.1136/bmjoq-2019-000669 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Article Rawlings, Deb Devery, Kim Poole, Naomi Improving quality in hospital end-of-life care: honest communication, compassion and empathy |
title | Improving quality in hospital end-of-life care: honest communication, compassion and empathy |
title_full | Improving quality in hospital end-of-life care: honest communication, compassion and empathy |
title_fullStr | Improving quality in hospital end-of-life care: honest communication, compassion and empathy |
title_full_unstemmed | Improving quality in hospital end-of-life care: honest communication, compassion and empathy |
title_short | Improving quality in hospital end-of-life care: honest communication, compassion and empathy |
title_sort | improving quality in hospital end-of-life care: honest communication, compassion and empathy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567943/ https://www.ncbi.nlm.nih.gov/pubmed/31259290 http://dx.doi.org/10.1136/bmjoq-2019-000669 |
work_keys_str_mv | AT rawlingsdeb improvingqualityinhospitalendoflifecarehonestcommunicationcompassionandempathy AT deverykim improvingqualityinhospitalendoflifecarehonestcommunicationcompassionandempathy AT poolenaomi improvingqualityinhospitalendoflifecarehonestcommunicationcompassionandempathy |