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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Using Family Narrative Reports to Identify Practices for Improving End-of-Life Care Quality.

Karleen F Giannitrapani¹, Maria Yefimova², Matthew D McCaa³

¹Center for Innovation to Implementation (K.F.G., M.Y., M.D.M., J.R.G., C.G., K.A.L.), VA Palo Alto Health Care System, Menlo Park, CA, USA; Division of Primary Care and Population Health (K.F.G., K.A.L.), Stanford University School of Medicine, Stanford, CA, USA.

Journal of Pain and Symptom Management

|July 8, 2022

Summary

This summary is machine-generated.

Bereaved families identified 98 actionable practices to improve end-of-life care quality in hospitals. These insights from the Bereaved Family Surveys (BFS) offer a valuable resource for healthcare systems seeking quality improvement strategies.

Keywords:

Palliative care bereaved family survey qualitative research quality improvement veterans affairs

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Area of Science:

Healthcare Quality Improvement
Patient-Centered Care
End-of-Life Care Research

Background:

Healthcare systems must consider patient experiences to enhance end-of-life care.
Families and caregivers of deceased inpatients are key informants for quality improvement.

Purpose of the Study:

To identify actionable practices for high-quality end-of-life care as highlighted by bereaved families.
To gather insights for systematic quality improvement in inpatient settings.

Main Methods:

Qualitative content analysis of narrative responses from the Bereaved Family Surveys (BFS) within the Veterans Health Administration.
Analysis of 1500 randomly selected responses, with an additional 300 for saturation confirmation.

Main Results:

Over 23% of analyzed responses contained actionable practices.
Identified 98 actionable practices from bereaved families, including 67 for end-of-life care and 31 for patient-centered domains.
Practices clustered into respectful care, communication, emotional/spiritual support, symptom management, and patient-centered domains.

Conclusions:

Narrative feedback from bereaved families provides a framework for systematic quality improvement.
These identified practices can serve as a practical guide for diverse healthcare settings aiming to improve the quality of death for inpatients.