ArticleBMJ open2020
Improving regional care in the last year of life by setting up a pragmatic evidence-based Plan-Do-Study-Act cycle: results from a cross-sectional survey.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- [Documentation of changes in goals of care in intensive care units - retrospective medical record analysis of deceased patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- [Change in goal-of-care in a cardiological intensive care unit-retrospective medical record analysis].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Promising Concept, Challenging Implementation of a Minimally Invasive Intervention (MINI) to Identify Patients in Their Last Year of Life-A Multi-Methods Feasibility Study at a German University Hospital.Healthcare (Basel, Switzerland) · 2025Article
- From MINI to Meaningful Change-A German Pilot Study to Improve Patient Outcomes in End-of-Life Care.Healthcare (Basel, Switzerland) · 2025Article
- How to Evaluate Hospital Care in the Dying Phase-Development of a Data Extraction Tool for Retrospective Medical Record Analysis.Journal of evaluation in clinical practice · 2025Article
- "What Do You Get? Nothing": A Qualitative Analysis of the Financial Impact of Family Caregiving for a Dying Relative at Home in Germany.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Report from the Fourth International Last Aid Conference: Last Aid and networks in community palliative care.Palliative care and social practice · 2024Article
- Top-down and bottom-up or participation through action? How to build a compassionate community - the experience of Caring Community Cologne.Palliative care and social practice · 2024Article
- What Keeps the Family Caregiver Motivated to Care for Their Dying Relative at Home? A Brief Report of a Qualitative Interview Study.Palliative medicine reports · 2024Article
- Quality of care in the last year of life: adaptation and validation of the German "Views of Informal Carers' Evaluation of Services - Last Year of Life - Cologne".BMC health services research · 2022Article
- Dying in hospital in Germany - optimising care in the dying phase: study protocol for a multi-centre bottom-up intervention on ward level.BMC palliative care · 2022Article
- Article
- What are the risk factors for avoidable transitions in the last year of life? A qualitative exploration of professionals' perspectives for improving care in Germany.BMC health services research · 2021Article
- Patient-centered care during the last year of life: adaptation and validation of the German PACIC short form for bereaved persons as proxies (PACIC-S9-proxy).BMC palliative care · 2020Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo set up a pragmatic Plan-Do-Study-Act cycle by analysing patient experiences and determinants of satisfaction with care in the last year of life.
designCross-sectional postbereavement survey.
settingRegional health services research and development structure representing all health and social care providers involved in the last year of life in Cologne, a city with 1 million inhabitants in Germany.
participants351 bereaved relatives of adult decedents, representative for age and gender, accidental and suspicious deaths excluded.
resultsFor the majority (89%) of patients, home was the main place of care during their last year of life. Nevertheless, 91% of patients had at least one hospital admission and 42% died in hospital. Only 60% of informants reported that the decedent had been told that the disease was leading to death. Hospital physicians broke the news most often (58%), with their communication style often (30%) being rated as 'not sensitive'. Informants indicated highly positive experiences with care provided by hospices (89% 'good') and specialist palliative home care teams (87% 'good'). This proportion dropped to 41% for acute care hospitals, this rating being determined by the feeling of not being treated with respect and dignity (OR=23.80, 95% CI 7.503 to 75.498) and the impression that hospitals did not work well together with other services (OR=8.37, 95% CI 2.141 to 32.71).
conclusionsFollowing those data, our regional priority for action now is improvement of care in acute hospitals, with two new projects starting, first, how to recognise and communicate a limited life span, and second, how to improve care during the dying phase. Results and further improvement projects will be discussed in a working group with the city of Cologne, and repeating this survey in 2 years will be able to measure regional achievements. TRIAL REGISTRATION NUMBER: DRKS00011925.
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