Healthcare systems should consider patient experiences while establishing care procedures to raise the standard of end-of-life care. Families and caregivers of recently deceased in-patients may be in the greatest position to suggest methods for quality enhancement. For a study, researchers sought to recognize strategies that can be put into practice that grieving families mention as helping to provide high-quality end-of-life care.

They conducted a qualitative content analysis of the narrative answers to the Veterans Health Administration inpatient decedents Bereaved Family Survey. In 2017, out of 5,964 completed surveys, 4,604 (or 77%) had at least one word in the open-ended responses. Therefore, 1,500/4,604 replies were randomly chosen for examination to determine viability. To ensure saturation, 300 more randomly chosen replies were examined.

More than 23% (355/1,500) of the initially examined story replies included implementable practices. They discovered 98 strategies that might be implemented in QI efforts by integrating narrative responses to the BFS in a national hospital system from bereaved families. They specifically identified 31 patient-centered care practices in the physical environment, food, staffing, coordination, technology, and transportation domains, as well as 67 end-of-life practices. The 67 are grouped into compassionate care & communication, spiritual and emotional support, death benefits, and symptom management. Implementation opportunities were highlighted by grouping these practices according to organizational transformation target levels.

Family members of the deceased can provide narrative replies that can lead to methods for systematically improving quality. The methods can be used as a menu in a variety of circumstances, searching for methods to enhance patients’ quality of dying in inpatient settings.