Improving the safety and quality of end-of-life in an Australian private hospital setting: An audit of documented end-of-life care

Objective This study reviewed the audit outcomes of the documented end-of-life care in a private hospital against the Australian Commission on Safety and Quality in Health Care's five recommended processes of care (Essential Elements (EE) 1-5). Methods A retrospective database review of deaths over a three-year period was undertaken. This was followed by a sequential medical record audit (n = 100) to evaluate the end-of-life care documented in the three days preceding death. Results There were 997 deaths from 2015 to 2017. The audit found communication to family the patient was dying (91%) and to the patient (36%) (EE1); evidence of specialist referral (68%) (EE2); assessment of the ability to eat/drink in the last 72 hours (86%) (EE3); advance care directives (13%) and hospital resuscitation plans (92%) (EE4); and response to patient or family concerns (100%) (EE5). Conclusions Components of the processes of care of the Essential Elements need to be addressed to improve patient-centred communication and shared decision-making.