Table 1. List of the 27 preliminary QIs reviewed by the expert panel, how they relate to the 6 themes identified in Phase I and which interRAI assessment can be used to generate the QI.
Name and brief description of each theme and QIs that relate to that theme | Failure to Improve | Follow-up prevalence |
---|---|---|
1. Access to care: coordination/continuity of care, access to care providers, access to services at the appropriate time | ||
Prevalence of emergency department visitsa,b | X | |
Prevalence of hospital admissionsa,b | X | |
2. Patient care: Discussion of preferred setting of death across the illness trajectory, advanced goals/care planning | ||
Prevalence of clients feeling that progress is not being made regarding completion of personal goalsb | X | |
Prevalence of no advance directivesb | X | |
Prevalence of clients feeling a lack of completion of financial, legal and other formal responsibilitiesb | X | |
3. Caregiver support: How to cope with distress/burden/loneliness, education for caregivers/knowledge to keep client at home, caregiver supports (networks, respite) | ||
Prevalence of caregiver distressa,b | X | |
4. Symptom management: Treating symptoms and also having a patient-centred approach to care | ||
Prevalence of fallsa,b | X | |
Prevalence of severe or excruciating daily paina,b | X | |
Prevalence of pain that is not controlled by medicationsa,b | X | |
Failure for pain to improvea,b | X | |
Prevalence of constipationa,b | X | |
Prevalence of shortness of breath at resta,b | X | |
Prevalence of shortness of breath upon exertiona,b | X | |
Failure for shortness of breath to improvea,b | X | |
Prevalence of stasis/pressure ulcersa,b | X | |
Prevalence of a delirium-like syndromea,b | X | |
Prevalence of nausea or vomitinga,b | X | |
Prevalence of fatiguea,b | X | |
Prevalence of sleep problemsa,b | X | |
Prevalence of poor self-reported healtha,b | X | |
Prevalence of negative mooda,b | X | |
Failure for negative mood to improvea,b | X | |
Prevalence of declining social activities that causes distressa | X | |
Prevalence of lonelinessa | X | |
Prevalence of anxious complaintsa,b | X | |
5. Spiritual care: Patient and their family should be provided resources and have access to spiritual care | ||
Prevalence of struggling with the meaning of lifeb | X | |
Prevalence of wanting to die nowb | X | |
6. Home as the preferred place of death: no QIs could be created to address this theme |
a indicates a QI that can be generated with the interRAI HC data
b indicates a QI that can be generated with the interRAI PC data