Families Perceptions of Care Related to End-Of-Life Care Visits

Date of Award

Spring 2022

Document Type

Dissertation

Degree Name

Doctor of Healthcare Administration (DHA)

Committee Chair

Gail Frankle

Committee Member

Alyncia Bowen

Committee Member

Olivia Pollard

Abstract

Hospice care in the United States focuses on the patient and family unit, aspiring to provide high-quality end-of-life care. Support and palliation of symptoms by the hospice, allows the patient to die comfortably and with dignity with the family by their side. One problem in hospice care is whether quality data reporting shows a correlation between publicly reported quality measures and the families’ experience of care. The quality data the public sees is the Hospice Item Set (HIS) data and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data, viewable publicly on the Hospice Compare site. This quantitative study compares the quality data reporting for Avow Hospice in Naples, Florida to determine if increasing visit frequencies, the last three days of life as reported on the HIS, improves the families’ experience of care for the CAHPS global measures questions 39 and 40. Forty-five months of data is captured in this study, comparing data from deaths from April 2017 through December 2020. The study results indicate that increasing visits the last three days of life yields no improvement in the families’ experience for CAHPS survey question 39, however there is evidence that it improves CAHPS survey question 40. Compounded by the Public Health Emergency (PHE), hospices had to become creative in the types and lengths of visits and services provided to hospice patients. Based on this research conducted, the elimination of the imminent measure pair, and the inception of the new Hospice Outcomes and Patient Evaluation (HOPE) assessment tool, further research is needed to identify the correlation between increased hospice care provider visits and the perceptions of families’ experiences.

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