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Application of quality audit tools to evaluate care quality received by terminal cancer patients admitted to a palliative care unit

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Abstract

Goals

We aimed to evaluate the palliative care quality for terminal cancer patients as a reference for prospective service improvements.

Patients and methods

A prospective study was conducted to analyze the quality audit data collected from 1,476 samples in one medical center’s palliative care unit. Lai’s modified version of the support team assessment schedule was utilized for 2-year data collection, applying 17 categories of audit criteria rated on a scale of 0 to 4 (0—no symptoms, 4—significant symptoms). The quality audit criteria were scored weekly for 2 weeks following patient admission.

Results

Average scores of quality audit criteria from admission to week 2 were 10.05, 8.85, and 8.49, respectively, with statistical differences noted weekly. Efficacy of palliative care was most evident 2 weeks after hospitalization. Factors with statistically significant differences between admission and week 1 included: pain control, constipation, vomiting, anorexia, other symptom control, patient anxiety, self awareness and preparation of patient for illness, self awareness and preparation of family for illness, and satisfaction of patient’s spiritual belief and life philosophy. Factors with statistically significant differences between weeks 1 and 2 included: pain control, other symptom control, self awareness and preparation of family for illness, and satisfaction of patient’s spiritual belief and life philosophy.

Conclusions

Patients in hospice care received adequate symptom relief. Total quality audit scores declined progressively over the 2 weeks following patient admission, indicating efficacy of palliative care quality.

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Acknowledgements

We would like to thank the affiliated research facility for assisting with data collection for our clinical quality audit of palliative care.

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Authors and Affiliations

  1. Department of Nursing, Mackay Memorial Hospital, No. 45, Minsheng Road, Danshui, 251, Taipei County, Taiwan, Republic of China

    Li-Yun Tsai, In-Fun Li, Ching-Ping Liu & Tse-Yun Change

  2. Mackay Medicine, Nursing and Management College, No.92, Shengjing Rd., Beitou District, 112, Taipei, Taiwan, Republic of China

    Li-Yun Tsai, In-Fun Li & Tse-Yun Change

  3. Mackay Palliative Care Center, Mackay Memorial Hospital, #45, Mingsheng Road, Danshui, 251, Taipei, Taiwan, Republic of China

    Wen-Hao Su

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  1. Li-Yun Tsai
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  2. In-Fun Li
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  3. Ching-Ping Liu
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  4. Wen-Hao Su
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  5. Tse-Yun Change
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Correspondence to Tse-Yun Change.

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Tsai, LY., Li, IF., Liu, CP. et al. Application of quality audit tools to evaluate care quality received by terminal cancer patients admitted to a palliative care unit. Support Care Cancer 16, 1067–1074 (2008). https://doi.org/10.1007/s00520-007-0365-1

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  • DOI: https://doi.org/10.1007/s00520-007-0365-1

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