Improving the safety and quality of end-of-life in an Australian private hospital setting: An audit of documented end-of-life care
Australasian Journal on Ageing
Centre for Research in Aged Care / School of Nursing and Midwifery
Edith Cowan University
Hollywood Private Hospital Research Foundation
Ron Woss Scholarship
Western Australian Nurses Memorial Charitable Trust
This study reviewed the audit outcomes of the documented end-of-life care in a private hospital against the Australian Commission on Safety and Quality in Health Care's five recommended processes of care (Essential Elements (EE) 1-5).
A retrospective database review of deaths over a three-year period was undertaken. This was followed by a sequential medical record audit (n = 100) to evaluate the end-of-life care documented in the three days preceding death.
There were 997 deaths from 2015 to 2017. The audit found communication to family the patient was dying (91%) and to the patient (36%) (EE1); evidence of specialist referral (68%) (EE2); assessment of the ability to eat/drink in the last 72 hours (86%) (EE3); advance care directives (13%) and hospital resuscitation plans (92%) (EE4); and response to patient or family concerns (100%) (EE5).
Components of the processes of care of the Essential Elements need to be addressed to improve patient-centred communication and shared decision-making.
Safety and quality in health care