Patient-Centered Preferred Practices
How often does your hospice staff monitor pain for patients who are receiving hospice in the home? Response: daily, every few days, weekly, less often How often does your hospice staff monitor each of the following symptoms (anxiety, constipation, delirium, depression, dyspnea, fatigue, nausea) for patients who are receiving hospice in the home? Response: daily, every few days, weekly, less often Which of the following standardized assessment tools for pain and symptom management are regularly used by your hospice? (Check all that apply) Response: Pain Assessment in Advanced Dementia Scale, Edmonton Symptom Assessment System, Brief Pain Inventory, Baker-Wong FACES Scale, only use tools customized by my hospice Does your hospice provide 24-hour crisis management phone access to patients and families? Response: yes, no Does your hospice have a physician on-call both evenings and weekend hours to provide clinical advice to family caregivers? Response: yes, no Which staff are expected to attend inter-disciplinary team meetings? (Check all that apply) Response: Physicians, Nurses, Speech/Occupational/Physical Therapists, Nutritionist/Registered Dieticians, Social Workers, Psychologists, Art/Music Therapists, Pharmacists, Pastoral Care/Chaplains, Volunteers, Administrators How often are patient goals of care included in discussions of patients’ plans of care? (Check all that apply) Response: at initial admission, when clinical conditions change, on a routine schedule, not discussed How often are each of the following (advance directives, who the legal surrogate is, patient preferences for place of death) included in discussions of patients’ plans of care? (Check all that apply) Response: at initial admission, when clinical conditions change, on a routine schedule, not discussed How often does your hospice track data on patient falls/serious injuries, and medication errors? Response: at least quarterly, annually, less often, not at all How often does your hospice track data on patient satisfaction? Response: at least quarterly, annually, less often, not at all
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Family-Centered Preferred Practices
Does your hospice have mechanisms in place to address conflicts of interest related to end-of-life care? (Check all that apply) Response: Yes, we have an established ethics committee; Yes, we have ombudsmen; No, we do not have any mechanism in place; don’t know How often are family preferences for care included in discussions of patients’ plans of care? (Check all that apply) Response: at initial admission, when clinical conditions change, on a routine schedule, not discussed When does your hospice screen family caregivers who may be at increased risk for the following conditions (major clinical depression, complicated/prolonged grief)? Response: at initial admission, routinely during the patient’s stay, at the time of death, we do not screen for this Does your bereavement staff provide pre-death planning? Response: yes, no Does your hospice provide bereavement services to family caregivers beyond 12 months after a patient’s death if the family desires it? Response: yes, no How often does your hospice track data on family caregiver satisfaction with bereavement services? Response: at least quarterly, annually, less often, not at all How often does your hospice track data on family caregiver satisfaction with hospice overall? Response: at least quarterly, annually, less often, not at all
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