Dying in hospital-staff perceptions on providing quality care

N Z Med J. 2022 Dec 16;135(1567):13-20. doi: 10.26635/6965.5911.

Abstract

Aim: To understand what healthcare staff perceive contributes to the quality of patient and family/whānau experiences of dying and death on a hospital inpatient ward.

Method: A survey was created, piloted and sent to all staff members who had cared for a deceased patient within two working days of their death, at Christchurch Hospital (CH), New Zealand. The survey comprised questions evaluating whether the patients physical, emotional, social or family/whānau needs were met, using both a Likert scale and free-text options. The survey was sent over a three-month period in 2016/2017.

Results: A total of 169 staff responded to the deaths of 51 patients. The majority (71.3%) of staff agreed that "end-of-life care was of a high standard", with the physical symptoms domain holding the highest score for both agreement (68%) and disagreement (13%) that "physical symptoms were well managed". Qualitative analysis of free-text responses revealed three themes: coordinated care (service delivery, complex case or communication needs, teamwork); culture of practice (dignity, trust, respect and relationships); and complexity of care (encompassing complex physical symptoms or patient or family/whānau interpersonal dynamics).

Conclusion: Evaluation of quality of death in hospitals can be enhanced by routine use of surveys of staff who cared for the deceased person. Such surveys could comprise part of a suite of tools to provide a holistic view of dying and death, complementing methods such as retrospective audits and family/whānau interviews.

MeSH terms

  • Hospice Care*
  • Hospitals
  • Humans
  • New Zealand
  • Retrospective Studies
  • Terminal Care* / psychology