Hospital care at the end of life: An institutional assessment

Laurie G. Jacobs, Karen Bonuck, William Burton, Michael Mulvihill

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Decisions about care at the end of life are not only influenced by doctor-patient-family relationships and physician practice, but also by institutional "culture." An institutional assessment of the quality of care provided to dying hospitalized patients was undertaken to characterize and identify factors influencing it and to find opportunities for improvement. An analysis of hospital data, three physician and nursing focus group discussions, structured review of records of targeted patients (61) who had an "expected death," and interviews with 31 surviving family members of the targeted patients served as the basis for an institutional needs assessment intended to precede the development of a quality improvement program to improve hospital care of patients at the end of life. Data were primarily gathered regarding older adults, including a significant number of nursing home residents. The assessment led to a methodology for developing a quality improvement program based upon feedback to physicians and nurses regarding the quality of end-of-life care.

Original languageEnglish (US)
Pages (from-to)291-298
Number of pages8
JournalJournal of Pain and Symptom Management
Issue number3
StatePublished - Sep 1 2002


  • Hospital end-of-life care
  • Institutional assessment
  • Quality of care

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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