Improving Care for the End of Life A Sourcebook for Health Care Managers and Clinicians

by Lynn, Joanne; Schuster, Janice Lynch; Kabcenell, Andrea

• ISBN13: 9780195116618
• ISBN10: 0195116615
• Format: Hardcover
• Copyright: 2000-10-05
• Publisher: Oxford University Press

Summary

"Improving Care for the End of Life provides expert guidance on how to make significant improvements now, at all levels of the health care system - from the bedside and the hospital to the health care policy and legislative arenas - by using the rapid cycle approach to change. The ideas are proven, and the stories of teams that have put them to use will inspire and enlighten."--BOOK JACKET.

Table of Contents

PART I: OVERVIEW
Introduction: Continuous Quality Improvement for Better End-of-Life Care	3	(8)
How to Make Improvement Happen	11	(26)
PART II: IMPROVED PATIENT CARE THROUGH IMPROVED PRACTICE AND SYSTEMS
Preventing, Assessing, and Treating Pain	37	(22)
Managing Dyspnea and Ventilator Withdrawal	59	(14)
Beyond the Living Will: Advance Care Planning for All Stages of Health and Disease	73	(18)
Relationships, Spirituality, and Bereavement: Supporting People in Difficult Times	91	(22)
Continuity of Care: Improving Patient Confidence in the Health Care System	113	(20)
PART III: ARRANGEMENTS TO PROMOTE REFORM
Hospital-Based Palliative Care Consults and Units	133	(18)
Medicare Reimbursement	151	(18)
Beyond Number Crunching: Ways to Use Information Systems in Quality Improvement	169	(10)
Caring for Caregivers: Helping Staff to Provide Good Care	179	(12)
Using Law and Policy to Improve End-of-Life Care	191	(24)
PART IV: OPPORTUNITIES IN SPECIFIC DISEASES
Alzheimer's and Other Dementias: Opportunities to Honor Life	215	(20)
Opportunities to Improve Care for Cancer Patients	235	(10)
Depression and Delirium	245	(12)
Offering End-of-Life Services to Patients with Advanced Heart or Lung Failure	257	(12)
Conclusion: Getting Started	269	(8)
Appendix: Instruments	277	(50)
Instruments to Measure Quality	278	(9)
Standards of Palliative Care	281	(6)
Instruments to Assess Pain and Physical Symptoms	287	(4)
Pain Assessment Tool	288	(3)
Instruments to Assess Survival Time and Aggressiveness of Care	291	(2)
Aggressiveness of Care Plan Discussion Documentation Sheet	291	(2)
Instruments to Assess Spirituality	293	(1)
Instruments to Assess Grief	294	(1)
Additional Instruments to Measure Quality	295	(1)
Multidimensional Instruments	296	(31)
HealthPartners Comfort Assessment	299	(2)
Parkland Hospital Referral Flowchart and Intake Form	301	(2)
End-of-Life Chart Review	303	(5)
After-Death Family Interview	308	(19)
Resources	327	(20)
Five Wishes	328	(10)
Elements of Care Checklist	338	(3)
Precepts of Palliative Care	341	(3)
Hospice Interdisciplinary Clinical Competencies	344	(3)
Glossary	347	(6)
References	353	(8)
Index	361