7.10 Clinical and organizational audit and quality improvement in palliative medicine

Author(s):  
Irene J. Higginson
Author(s):  
Carolina De Elia ◽  
Phyllis Macchio ◽  
Wardah Khan ◽  
Lindsay Perigini ◽  
Alan Kaell ◽  
...  

Palliative medicine can be essential in helping to align patients’ goals of care with their treatment team. Referrals for palliative medicine are more advantageous when initiated in the emergency department as this is the first point of contact for seriously ill patients being admitted to the hospital. This paper highlights a quality improvement project initiated to address knowledge gaps in palliative medicine with emergency department (ED) staff and to increase referrals for palliative medicine from the ED. The palliative medicine staff held an in-service training with the ED staff which focused on defining palliative medicine and the importance of early consults when the patient presents in the ED. Palliative medicine staff also highlighted the differences between palliative medicine and hospice care, when and how to initiate a consult for palliative medicine, as well as how to contact the palliative medicine division. The results showed that after this educational intervention the number of palliative medicine consults increased three-fold. Before the educational intervention, monthly averages for palliative medicine were 6 and after rose to 18.9 per month.


Author(s):  
Irene J. Higginson

Audit approaches and methods are now well advanced in palliative care, especially in clinical audit. This chapter discusses these approaches and methods, and addresses such questions as ‘Why perform clinical audit in palliative medicine?’ and ‘How do we assess the quality of palliative care?’ It discusses the evolving terms of audit, quality improvement, and governance, and how to apply clinical audit to palliative medicine. Audit requires resources, and so it must be sure to benefit patients and families, be kept as simple and efficient as possible, and have a strong educational component. There is also a need to develop and test methods of audit in developing countries. If palliative approaches extend backwards to include patients earlier in care, rather than those just near to death, then the audit could become a means for clinical dialogue and education between specialties.


2019 ◽  
Vol 36 (7) ◽  
pp. 603-607 ◽  
Author(s):  
Christina Wood ◽  
Susanne M. Cutshall ◽  
Rachel M. Wiste ◽  
Rachel C. Gentes ◽  
Johanna S. Rian ◽  
...  

2021 ◽  
pp. 1335-1350
Author(s):  
Irene J. Higginson ◽  
Mevhibe B. Hocaoglu

Audit approaches and methods are now well advanced in palliative care, especially in clinical audit. This chapter discusses these approaches and methods, and addresses such questions as ‘Why perform clinical audit in palliative medicine?’ and ‘How do we assess the quality and safety of palliative care?’ It discusses the evolving terms of audit, quality assurance, quality improvement, safety, and governance, and how to apply clinical audit to palliative medicine. Audit requires resources, and so it must be sure to benefit patients and families, be kept as simple and efficient as possible, and have a strong educational component. There is also a need to develop and test methods of audit in a global healthcare context. If palliative approaches extend backwards to include patients earlier in care, rather than those just near to death, then the audit could become a means for clinical dialogue and education between specialties.


2007 ◽  
Vol 40 (6) ◽  
pp. 1-4
Author(s):  
BRUCE K. DIXON
Keyword(s):  

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