The long-term objective of this proposal is to improve the quality of end-of-life care provided by physicians.
Specific aims are: 1) to establish the measurement characteristics of the questionnaire developed and pilot-tested by the team to assess physician performance at specific end-of-life care skills; 2) to assess the quality of end-of-life care provided by physicians who commonly care for dying patients, including oncologists, pulmonologists, cardiologists and nursing home physicians; 3) to explore mechanisms for implementing interventions for improving physician care for patients at end-of-life. This is a prospective cohort study of 120 physicians in the Northwest and Southeast United States. Physicians will each identify 15 patients (total=1,800) with life-limiting illness. We will enroll patients and a family member for each patient, as well as 15 nurses per physician (total=1,800) who are familiar with the physician?s skills. All participants will complete questionnaires assessing the physician?s skill at end-of-life care. The questionnaire data will be evaluated for measurement structure, reliability, and validity; respondent differences in questionnaire data will also be examined. We will provide feedback to physicians based on the questionnaire data. The study will identify specific strengths and weaknesses in end-of-life care provided by individual physicians and by physicians within the specialties under study. It will also provide exploratory data on present and potential nursing roles in improving end-of-life care. The validated questionnaire will be useful in educational, clinical, and research settings to assess and improve the quality of end-of-life care by physicians. The results will allow investigators and others to develop targeted educational and systemic interventions to improve the quality of this care.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
5R01HS011425-02
Application #
6624123
Study Section
Health Care Quality and Effectiveness Research (HQER)
Program Officer
Hughes, Ronda
Project Start
2002-05-01
Project End
2005-04-30
Budget Start
2003-05-01
Budget End
2004-04-30
Support Year
2
Fiscal Year
2003
Total Cost
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Engelberg, Ruth A; Downey, Lois; Wenrich, Marjorie D et al. (2010) Measuring the quality of end-of-life care. J Pain Symptom Manage 39:951-71
Reinke, Lynn F; Shannon, Sarah E; Engelberg, Ruth et al. (2010) Nurses' identification of important yet under-utilized end-of-life care skills for patients with life-limiting or terminal illnesses. J Palliat Med 13:753-9