國立虎尾科技大學 |

Quality and Quality Improvement in End-of-life Care : = Perceptions of Hospice Providers.

紀錄類型:	書目-語言資料,手稿 : Monograph/item
正題名/作者:	Quality and Quality Improvement in End-of-life Care :/
其他題名:	Perceptions of Hospice Providers.
作者:	Johnson, Karen E.
面頁冊數:	1 online resource (370 pages)
附註:	Source: Dissertations Abstracts International, Volume: 81-12, Section: B.
Contained By:	Dissertations Abstracts International81-12B.
標題:	Health care management. -
電子資源:	click for full text (PQDT)
ISBN:	9798645460976

Quality and Quality Improvement in End-of-life Care : = Perceptions of Hospice Providers.
Johnson, Karen E.

Quality and Quality Improvement in End-of-life Care :Perceptions of Hospice Providers. - 1 online resource (370 pages)

Source: Dissertations Abstracts International, Volume: 81-12, Section: B.

Thesis (Ph.D.)--University of Maryland, Baltimore County, 2020.

Includes bibliographical references

Hospice is both a philosophy of care and a system for delivering care to patients near the end of life. The goals of hospice are to provide comfort care around the process of dying and to support the dying individual and his/her family members. Hospice care focuses not only on physical aspects of care, but also on social, emotional, spiritual, cultural, and ethical aspects. In recent years, there has been increasing interest among clinicians, researchers, and others to improve the quality of care provided through hospice. Yet relatively little research has focused on the perceptions of quality improvement (QI) among hospice staff, even though such perceptions may influence both their engagement in, and the ultimate success of, agencies' QI efforts. The goal of this study was to examine how hospice staff perceive efforts to improve quality of care in the hospice setting. This qualitative study employed an ethnographic and phenomenological approach to elicit narratives and meanings of end-of-life (EOL) care quality and its improvement from 19 directors, nurses, chaplains, and social workers from five hospice agencies in Maryland. Study participants articulated five interrelated meanings of QI: formal processes, learning on the part of hospice providers, changes in documentation to support compliance, "doing better," and activities that positively impact patients and families. They agreed that the quality of EOL care can be improved, and, for the most part, their views of QI were positive. Yet they also expressed skepticism about QI efforts. Front-line hospice workers had fairly broad, generalized knowledge regarding the QI efforts of their agencies, but limited familiarity with how those efforts were chosen. Participants reported engaging in improvement activities, although not all of those activities were part of their agencies' formal QI efforts. Furthermore, they identified education as a key mechanism to help them more effectively improve the quality of care they provide. Finally, this study found that participants' perceptions of quality EOL care and QI were linked to their occupational roles, but not to the characteristics of their agencies. Implications of these findings for hospice policy and practice are discussed, as are ideas for future research.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2024

Mode of access: World Wide Web

ISBN: 9798645460976Subjects--Topical Terms:

1148454
Health care management.
Subjects--Index Terms:

End-of-life careIndex Terms--Genre/Form:

554714
Electronic books.

Quality and Quality Improvement in End-of-life Care : = Perceptions of Hospice Providers.
LDR:03671ntm a22003857 4500 001 1145791
005 20240711091218.5
006 m o d
007 cr bn ---uuuuu
008 250605s2020 xx obm 000 0 eng d
020 $a 9798645460976
035 $a (MiAaPQ)AAI27960022
035 $a AAI27960022
040 $a MiAaPQ $b eng $c MiAaPQ $d NTU
100 1 $a Johnson, Karen E. $3 808365
245 1 0 $a Quality and Quality Improvement in End-of-life Care : $b Perceptions of Hospice Providers.
264 0 $c 2020
300 $a 1 online resource (370 pages)
336 $a text $b txt $2 rdacontent
337 $a computer $b c $2 rdamedia
338 $a online resource $b cr $2 rdacarrier
500 $a Source: Dissertations Abstracts International, Volume: 81-12, Section: B.
500 $a Advisor: Morgan, Leslie.
502 $a Thesis (Ph.D.)--University of Maryland, Baltimore County, 2020.
504 $a Includes bibliographical references
520 $a Hospice is both a philosophy of care and a system for delivering care to patients near the end of life. The goals of hospice are to provide comfort care around the process of dying and to support the dying individual and his/her family members. Hospice care focuses not only on physical aspects of care, but also on social, emotional, spiritual, cultural, and ethical aspects. In recent years, there has been increasing interest among clinicians, researchers, and others to improve the quality of care provided through hospice. Yet relatively little research has focused on the perceptions of quality improvement (QI) among hospice staff, even though such perceptions may influence both their engagement in, and the ultimate success of, agencies' QI efforts. The goal of this study was to examine how hospice staff perceive efforts to improve quality of care in the hospice setting. This qualitative study employed an ethnographic and phenomenological approach to elicit narratives and meanings of end-of-life (EOL) care quality and its improvement from 19 directors, nurses, chaplains, and social workers from five hospice agencies in Maryland. Study participants articulated five interrelated meanings of QI: formal processes, learning on the part of hospice providers, changes in documentation to support compliance, "doing better," and activities that positively impact patients and families. They agreed that the quality of EOL care can be improved, and, for the most part, their views of QI were positive. Yet they also expressed skepticism about QI efforts. Front-line hospice workers had fairly broad, generalized knowledge regarding the QI efforts of their agencies, but limited familiarity with how those efforts were chosen. Participants reported engaging in improvement activities, although not all of those activities were part of their agencies' formal QI efforts. Furthermore, they identified education as a key mechanism to help them more effectively improve the quality of care they provide. Finally, this study found that participants' perceptions of quality EOL care and QI were linked to their occupational roles, but not to the characteristics of their agencies. Implications of these findings for hospice policy and practice are discussed, as are ideas for future research.
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2024
538 $a Mode of access: World Wide Web
650 4 $a Health care management. $3 1148454
650 4 $a Gerontology. $3 559846
653 $a End-of-life care
653 $a Hospice
653 $a Perceptions
653 $a Qualitative research
653 $a Quality improvement
655 7 $a Electronic books. $2 local $3 554714
690 $a 0351
690 $a 0769
710 2 $a University of Maryland, Baltimore County. $b Gerontology. $3 1471011
710 2 $a ProQuest Information and Learning Co. $3 1178819
773 0 $t Dissertations Abstracts International $g 81-12B.
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27960022 $z click for full text (PQDT)