Taylor, D. R., Bouttell, J. , Campbell, J. N. and Lightbody, C. J. (2020) A case-controlled study of relatives’ complaints concerning patients who died in hospital: the role of treatment escalation / limitation planning. International Journal for Quality in Health Care, 32(3), pp. 212-218. (doi: 10.1093/intqhc/mzaa008) (PMID:32186717)
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Abstract
Objectives To independently assess quality of care among patients who died in hospital and whose next-of-kin submitted a letter of complaint and make comparisons with matched controls. To identify whether use of a treatment escalation limitation plan (TELP) during the terminal illness was a relevant background factor. Design The study was an investigator-blinded retrospective case-note review of 42 complaints cases and 72 controls matched for age, sex, ward location and time of death. Setting The acute medical and surgical wards of three District General Hospitals administered by NHS Lanarkshire, Scotland. Participants None. Intervention None. Outcome measures Quality of care: Clinical ‘problems’, non-beneficial interventions (NBIs) and harms were evaluated using the Structured Judgment Review Method. Complaints were categorized using the Healthcare Complaints Analysis Tool. Results The event frequencies and rate ratios for clinical ‘problems’, NBIs and harms were consistently higher in complaint cases compared to controls. The difference was only significant for NBIs (P = 0.05). TELPs were used less frequently in complaint cases compared to controls (23.8 versus 47.2%, P = 0.013). The relationship between TELP use and the three key clinical outcomes was nonsignificant. Conclusions Care delivered to patients at end-of-life whose next-of-kin submitted a complaint was poorer overall than among control patients when assessed independently by blinded reviewers. Regular use of a TELP in acute clinical settings has the potential to influence complaints relating to end-of-life care, but this requires further prospective study.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Bouttell, Dr Janet |
Authors: | Taylor, D. R., Bouttell, J., Campbell, J. N., and Lightbody, C. J. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment |
Journal Name: | International Journal for Quality in Health Care |
Publisher: | Oxford University Press |
ISSN: | 1353-4505 |
ISSN (Online): | 1464-3677 |
Published Online: | 18 March 2020 |
Copyright Holders: | Copyright © The Author(s) 2020 |
First Published: | First published in International Journal for Quality in Health Care32(3):212–218 |
Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
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