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Perspectives on Quality at the End of Life
Arch Pediatr Adolesc Med. 2004;158:415-418.
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What constitutes excellent care for the dying and, ultimately, a "good" death? Defining quality indicators for pediatric palliative, end-of-life, and bereavement (P-EOL-B) care—indicators that measure both the quality of care processes (such as providing emotional and spiritual support) and the attainment of outcomes valued by patients and families (such as freedom from pain or dying in a place of one's own choosing)—is a crucial challenge in our efforts to improve the care for dying children and their families.1-2
In this issue of the ARCHIVES, Andresen et al3 further our quest to identify P-EOL-B care quality indicators through their assessment of physicians' and nurses' perceptions regarding aspects of care provided to a series of 142 children who died in a children's hospital. Ninety-four percent of physicians reported that the child they cared for was "at peace" during the final days of life, yet only 72% of nurses reported likewise. Similarly, 71% . . . [Full Text of this Article] COLLABORATE, COMMUNICATE, AND SUPPORT DECISION MAKING
MINIMIZE BOTHERSOME SYMPTOMS
PROVIDE EMOTIONAL AND SPIRITUAL SUPPORT
MAXIMIZE OTHER QUALITY-OF-LIFE ENHANCERS
INSTITUTE P-EOL-B CARE IN A TIMELY MANNER
VISUALIZE AND ADDRESS THE FULL POPULATION AT NEED
PROVIDE A CONTINUUM OF CARE ACROSS MULTIPLE SITES
APPRECIATE AND MANAGE TRADEOFFS ADROITLY
OPERATE IN ACCORD WITH AN EVIDENCE BASE TO MAXIMIZE SAFETY AND EFFECTIVENESS
PRACTICE THE ART OF INDIVIDUALIZATION
Chris Feudtner, MD, PhD, MPH
Philadelphia, Pa
RELATED ARTICLE
Provider Perceptions of Child Deaths
Elena M. Andresen, Grace A. Seecharan, and Suzanne S. Toce
Arch Pediatr Adolesc Med. 2004;158(5):430-435.
ABSTRACT
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