CHSU Discovery

Introduction: Admission to hospice care can be a stressful period for patients and their families, causing important information to be overlooked. Research has not yet been conducted to identify what pertinent information is forgotten by patients and caregivers after the admissions on-boarding process. The potential for digital resources to address these gaps is a novel area of exploration. We aim to identify areas of improvement at Compassionate Care (CC) regarding the admissions process for hospice care patients and their family members. We conducted at least 40 surveys amongst CC employees and will create a digital informational FAQ guide for the patients by May of 2025 in order to direct future quality improvement measures. 

Methods: A survey was conducted to 60 CC staff to identify gaps in the admissions process. The anonymous surveys were distributed via the company email and included free response, yes/no, and Likert scale questions. Survey results were utilized to create an informational digital Frequently Asked Questions (FAQ) guide aimed at addressing these knowledge deficits. 

Results: A total of 42 CC staff members filled out the survey (70% response rate). Most respondents identified as female (25/42, 60%) and were nurses (28/42, 67%). Most (38/42, 90%) have been working at CC for three years or less, and over half (22/42, 52%) were involved in at least ten hospice admissions. Most respondents (33/42, 79%) found the admissions process adequate but noted a need for better patient and family education regarding hospice care, hospice philosophy, CC contacts, and expected outcomes during hospice. Four (10%) respondents felt that the current admissions binder was ineffective. While a majority (71%) believed the amount of information at admissions was sufficient, 19% saw gaps, and 7% felt it was excessive. Additionally, 40% of respondents believed that hospice care was delivered sensitively in terms of healthcare literacy and cultural competency. Overall admissions feedback is believed to be positive (15, 36%), but negative feedback (6, 14%) included feeling overwhelmed, lack of clear explanations, language barriers, “too early” visits, and perceived lack of compassion. Most respondents (50%) felt that family members expressed confusion and frustration about the admissions process. Key concerns included hospice as a concept (7/24, 29%), information overload (5/24, 21%), nurse visit scheduling (5/24, 21%) and medications (4/24, 17%). At least 1/3 of respondents (14/42) utilized external resources during their admission process such as information about available services (chaplain, social services) and primary diagnosis education. Additionally, digital resources (23/42), premade FAQ videos (23/41), multilingual admissions resources (22/42), and live texting/chat services would improve the admissions process. 

Conclusion: Our results highlight the need for better education regarding hospice care and its philosophy as well as expectations regarding prognosis and outcomes for patients and their families. An “FAQ Sheet” with commonly asked questions can be helpful in streamlining initial admissions and managing the volume of information being provided. Future efforts should be aimed at creating a digital database of resources and admissions materials, as our results indicate a need for such resources.