Universität zu Köln

Kremeike, Kerstin, Ullrich, Anneke, Schulz, Holger, Rosendahl, Carolin, Bostroem, Kathleen, Kaur, Sukhvir, Oubaid, Nikolas, Plathe-Ignatz, Christina, Leminski, Christin, Hower, Kira, Pfaff, Holger ORCID: 0000-0001-9154-6575, Hellmich, Martin, Oechsle, Karin and Voltz, Raymond (2022). Dying in hospital in Germany - optimising care in the dying phase: study protocol for a multi-centre bottom-up intervention on ward level. BMC Palliat. Care, 21 (1). LONDON: BMC. ISSN 1472-684X

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Abstract

Background: Hospitals are globally an important place of care for dying people and the most frequent place of death in Germany (47%), but at the same time, the least preferred one - for both patients and their relatives. Important indicators and outcome variables indexing quality of care in the dying phase are available, and various proposals to achieve corresponding quality objectives exist. However, they are not yet sufficiently adapted to the heterogeneous needs of individual hospital wards. Methods: This multi-centre single-arm pre-post study aims at the development and implementation of context-specific measures in everyday clinical practice, followed by evaluating this approach. Therefore, (1) already existing measures regarding optimal care in the dying phase are identified applying a systematic literature review as well as an online survey and a symposium with experts. Supported by the thereby generated collection of measures, (2) a stratified sample of ten teams of different wards from two university hospitals select suitable measures and implement them in their everyday clinical practice. Circumstances of patients' deaths on the selected wards are recorded twice, at baseline before application of the self-chosen measures and afterwards in a follow-up survey. Retrospective file analysis of deceased persons, quantitative staff surveys as well as qualitative multi-professional focus groups and interviews with relatives form the data basis of the pre-post evaluation. (3) Results are reviewed regarding their transferability to other hospitals and disseminated (inter-)nationally. Discussion: Measures that are easy to implement and appropriate to the specific situation are supposed to significantly improve the quality of care during the dying phase in hospitals and contribute to the well-being of dying 1 patients and their relatives. Successful implementation of those measures requires consideration of the individual conditions and needs of patients and their relatives-but also of the health professionals-on the different hospital wards. Therefore, a bottom-up approach, in which the ward-specific situation is first analysed in detail and then the staff itself selects and implements measures to improve care, appears most promising for optimising care in the dying phase in hospitals.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kremeike, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ullrich, Anneke UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulz, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosendahl, Carolin UNSPECIFIED UNSPECIFIED UNSPECIFIED Bostroem, Kathleen UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaur, Sukhvir UNSPECIFIED UNSPECIFIED UNSPECIFIED Oubaid, Nikolas UNSPECIFIED UNSPECIFIED UNSPECIFIED Plathe-Ignatz, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Leminski, Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hower, Kira UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfaff, Holger UNSPECIFIED orcid.org/0000-0001-9154-6575 UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Oechsle, Karin UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-668951
DOI:	10.1186/s12904-022-00960-1
Journal or Publication Title:	BMC Palliat. Care
Volume:	21
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1472-684X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PALLIATIVE CARE; CANCER-PATIENTS; PATIENT; LIFE; IMPLEMENTATION; PHYSICIANS; RECOVERY; DEATHS; PEOPLE; BUNDLE Multiple languages Health Care Sciences & Services; Health Policy & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66895