Standards & Audit

Audit & Review of End-of-Life Care

‘An opportunity to press the pause button’

In 2008 the Hospice Friendly Hospitals Programme commissioned the National Audit of End-of-Life Care in Irish hospital, the first of its kind in the EU. The report was published in 2010 and can be downloaded here. Data was collected on a sample of 1,000 patients who died in acute and community hospitals from the perspectives of nurses, doctors and relatives who spent the most time with the patient during their last week of life. The audit demonstrated the scope for improvement in relation to end-of-life care in Irish Hospitals and detailed analysis identified 8 domains which are statistically significant influences on the care for patients at end of life. These domains are:  Pain & symptom management, single room, preferred place of care, care planning, team work, moment of death and after, facilitating relatives, staff learning & development.

8 domains of care

Building on the 2010 National Audit, the Irish Hospice Foundation has developed an Audit & Review Tool to facilitate healthcare staff  to meet as a team to review and reflect on the care given to patients who died in their care and to identify areas for improvement.  The audit tool is designed around the 8 domains of care emerging from the 2010 national audit, (illustrated above) and can be used to review care of people who died in the acute hospitals, community units and nursing homes. It has also been used to audit care of people who died at home. Our work in relation to the National Audit of End-of-Life Care is underpinned the Quality Standards for End of Life Care in Hospitals.

In 2011 the Irish Hospice Foundation’s, Hospice Friendly Hospitals Programme established a Steering Committee to oversee the development of a Survey of Bereaved Relatives, as one component of a new National End-of-Life Care Audit and Review System, building on that which was developed in 2008. The new system aims to support a process of continuous improvement in the care of persons at the end of life, including their families.  Hearing the Voice of Bereaved Relatives Report was published in March 2015 and highlights the main findings from that survey, with reference to published standards within each domain. NEW: Download Hearing the Voice of Bereaved Relatives Report here. Download the series of National Audit reports here. Download the National Audit of End-of-Life Care in Hospitals in Ireland, 2008/9 Download the Quality Standards for End of Life Care in Hospitals here. Contact us for the Audit & Review Tool and guidance on to facilitate an audit meeting with healthcare teams.

Survey of Bereaved Relatives/Friends – VOICES MaJam

The Mater Hospital and St. James’s Hospital (North and South side of Dublin City) have commenced a joint research project to survey bereaved relatives and friends on the experience of end of life care in their respective hospitals. Commencing in May 2015, approximately 400 bereaved relatives in each site will be asked to complete a postal survey entitled 'VOICES MaJam', which has been adapted by the research team from the UK (Addington-Hall, University of Southampton - http://www.southampton.ac.uk/voices/about_voices/ ) for the Irish acute hospital setting. The study aims to gather direct feedback on the care experiences at end of life for patients and their family and friends. Secondly the survey findings will support a process of continuous improvement in the care of persons at the end of life, including their families. This project is funded by the Irish Hospice Foundation in partnership with the Mater Hospital, St James's Hospital, Trinity College Dublin and University College Dublin. The Mater/St. James’s/Trinity/ UCD collaboration envisages that the VOICES MaJam survey will be the first step towards the establishment of a standardized system of collecting and processing views of bereaved relatives and friends in order to improve the quality of end-of-life care in our hospitals. The tool will be made available to other acute hospitals upon completion of the study. Click here to read more about the Irish Hospice Foundation grants scheme      
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