Application of quality audit tools to evaluate care quality received by terminal cancer patients admitted to a palliative care unit

Goals We aimed to evaluate the palliative care quality for terminal cancer patients as a reference for prospective service improvements. Patients and methods A prospective study was conducted to analyze the quality audit data collected from 1,476 samples in one medical center's palliative care unit. Lai's modified version of the support team assessment schedule was utilized for 2-year data collection, applying 17 categories of audit criteria rated on a scale of 0 to 4 (0 - no symptoms, 4 - significant symptoms). The quality audit criteria were scored weekly for 2 weeks following patient admission. Results Average scores of quality audit criteria from admission to week 2 were 10.05, 8.85, and 8.49, respectively, with statistical differences noted weekly. Efficacy of palliative care was most evident 2 weeks after hospitalization. Factors with statistically significant differences between admission and week 1 included: pain control, constipation, vomiting, anorexia, other symptom control, patient anxiety, self awareness and preparation of patient for illness, self awareness and preparation of family for illness, and satisfaction of patient's spiritual belief and life philosophy. Factors with statistically significant differences between weeks 1 and 2 included: pain control, other symptom control, self awareness and preparation of family for illness, and satisfaction of patient's spiritual belief and life philosophy. Conclusions Patients in hospice care received adequate symptom relief. Total quality audit scores declined progressively over the 2 weeks following patient admission, indicating efficacy of palliative care quality.