Table 3.
End-of-Life Care Survey Outcomes Comparing Patients Who Received or Did Not Receive the 3 Wishes Program
| Number of respondents agreeing, N (%) | Adjusted 3WP vs usual care odds ratio | ||||
|---|---|---|---|---|---|
| 3WP (N = 117) |
Usual care (N = 197) |
p value | Adjusted value* | p value | |
| Bereaved family survey items (regarding last month of life) | Odds ratio (95% CI) | ||||
| Respectful care and communication | |||||
| Staff always took the time to listen | 90 (78.3%) | 135 (72.6%) | 0.270 | 1.70 (0.87 to 3.40) | 0.127 |
| Staff always provided treatment the patient wanted | 86 (74.8%) | 134 (72.4%) | 0.654 | 1.29 (0.66 to 2.54) | 0.464 |
| Staff were always kind, caring, and respectful | 96 (83.5%) | 154 (81.1%) | 0.593 | 1.48 (0.68 to 3.27) | 0.327 |
| Staff always kept family informed about the patient’s condition and treatment | 87 (75.7%) | 118 (62.8%) | 0.020 | 2.47 (1.30 to 4.83) | 0.006 |
| Staff always attended to the patient’s personal care needs (bathing, dressing, eating meals) | 76 (66.1%) | 120 (65.2%) | 0.878 | 1.22 (0.66 to 2.31) | 0.529 |
| Care around time of death | |||||
| Staff alerted the family that the patient was about to die | 100 (87.7%) | 170 (88.5%) | 0.829 | 0.64 (0.26 to 1.59) | 0.337 |
| Management of symptoms | |||||
| Patient did not experience pain | 37 (33.0%) | 70 (38.9%) | 0.313 | 0.89 (0.46 to 1.70) | 0.722 |
| Pain never made patient uncomfortable | 23 (26.1%) | 33 (24.3%) | 0.752 | 1.01 (0.43 to 2.35) | 0.986 |
| Emotional and spiritual support | |||||
| Staff always provided family/patient with spiritual support | 60 (54.5%) | 72 (40.4%) | 0.020 | 1.79 (0.98 to 3.30) | 0.061 |
| Staff always provided family/patient with emotional support | 74 (65.5%) | 95 (51.9%) | 0.022 | 2.52 (1.37 to 4.75) | 0.003 |
| Staff always provided family with emotional support after patient’s death | 73 (65.2%) | 102 (54.3%) | 0.063 | 2.70 (1.44 to 5.22) | 0.002 |
| Performance measure | |||||
| Excellent overall rating of care received during last month of life | 79 (69.3%) | 119 (63.0%) | 0.262 | 1.48 (0.79 to 2.82) | 0.220 |
| Additional questions | |||||
| Patient died in the right place | 78 (69.6%) | 159 (81.5%) | 0.017 | 0.75 (0.36 to 1.59) | 0.457 |
| Hospital definitely worked well with primary care and other providers | 51 (45.5%) | 100 (53.2%) | 0.200 | 1.63 (0.90 to 2.97) | 0.107 |
| No decisions were made that the patient would not have wanted | 90 (78.3%) | 151 (79.9%) | 0.733 | 0.77 (0.38 to 1.57) | 0.470 |
| BFS factor scores | Unadjusted median (IQR) | β coefficient* | |||
| Respectful care and communication factor score (N = 284) | 14.0 (12 to 15) | 14.0 (11 to 15) | 0.225 | 0.89 (− 0.04 to 1.83) | 0.063 |
| Emotional and spiritual support factor score (N = 277) | 7.5 (6–9) | 6.0 (3–9) | 0.003 | 1.37 (0.54 to 2.19) | 0.001 |
Missing data for survey questions ranged from 0 to 8.3%
*Adjust for age, gender, marital status, respondent’s relationship to patient, race/ethnicity, primary language, type of insurance, type of ICU, presence of COVID-19 infection, palliative care consultation during hospitalization, presence of an advance directive or POLST, and need for mechanical ventilation, vasopressors, and dialysis