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Improving Quality of Care for the Dying Patient in Hospice: A Quasi Experimental Trial in Liguria Region

Phase 2
Completed
Conditions
End-of-Life
Interventions
Other: LCP Program
Registration Number
NCT01470625
Lead Sponsor
Regional Palliative Care Network
Brief Summary

This is a before-after phase II study, according to the Medical Research Council framework, investigating the feasibility of introducing the Liverpool Care Pathway for the dying patient (LCP) in 5 Ligurian hospices.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
282
Inclusion Criteria
  • All patients deceased in the hospice during the evaluation period
  • Approval of ethics committee
Exclusion Criteria
  • Prior use of LCP in the hospice
  • Deceased was a relative of a hospice member of staff

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
LCP ProgramLCP ProgramThe LCP Program is continuous quality improvement program of end-of-life care implemented in hospice
Primary Outcome Measures
NameTimeMethod
feasibility of LCP implementation6 months after the end of LCP implementation

measured as proportion of hospices that complete the experimental phase of introducing the LCP Program and maintain the program in the 6 months subsequent the process of experimental LCP implementation

Secondary Outcome Measures
NameTimeMethod
quality of information provided to patients and to family2-4 months after the patient's death

measured with the scale 1 (Informing and promoting shared decision making) from the Toolkit After-death bereaved family member interview (Teno 2001). The Toolkit will be administered to non-professional caregivers 2-4 months after the patient's death

Level of advanced care planning among patients2 - 4 months after the patient's death

measured with the scale 2 (Encouraging advance care planning) from the Toolkit After-death bereaved family member interview (Teno 2001). The Toolkit will be administered to non-professional caregivers 2-4 months after the patient's death

Provision of care focusing on patient's individual needs.2 - 4 months after the patient's death

measured with the scale 3 (Focus on individual) from the Toolkit After-death bereaved family member interview (Teno 2001). The Toolkit will be administered to non-professional caregivers 2-4 months after the patient's death

Quality of emotional support to family members before an after the patient's death2 - 4 months after the patient's death

measured with the scale 4 (Attending to the emotional and spiritual needs of the family) from the Toolkit After-death bereaved family member interview (Teno 2001). The Toolkit will be administered to non-professional caregivers 2-4 months after the patient's death

Level of care coordination2 - 4 months after the patient's death

measured with the scale 5 (Providing coordination of care) from the Toolkit After-death bereaved family member interview (Teno 2001). The Toolkit will be administered to non-professional caregivers 2-4 months after the patient's death

Family support levels2 - 4 months after the death of the patient

measured with the scale 6 (Supporting the self-efficacy of the family) from the Toolkit After-death bereaved family member interview (Teno 2001). The Toolkit will be administered to non-professional caregivers 2-4 months after the patient's death

Appropriateness of therapeutic and diagnostic proceduresthe last 3 days of life

measured with a specific tool in which all diagnostic and therapeutic procedures and drugs administered to the patient during the last 3 days of life are reported

Overall quality of care experience for patients and family2 - 4 months after the death of the patient

measured with the scale 7 (Overall quality of care provided to patients and family) from the Toolkit After-death bereaved family member interview (Teno 2001). The Toolkit will be administered to non-professional caregivers 2-4 months after the patient's death

Quality of communication between General Practitioner and hospicean expected average of 2 months after the patient's death

measured with a telephonic interview

Trial Locations

Locations (5)

Hospice ASL 4

🇮🇹

Chiavari, Genova, Italy

CENTRO MISERICORDIA" SANTA M.G.ROSSELLO. Ist.Figlie Ns Signora Misericordia

🇮🇹

Savona, Italy

Hospice Gigi Ghirotti "Albaro"

🇮🇹

Genova, Italy

Hospice Gigi Ghirotti "Bolzaneto"

🇮🇹

Genova, Italy

Hospice ASL1 Liguria

🇮🇹

Imperia, Italy

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