Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians / Edition 2

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Health care professionals seeking to improve the quality of life for those living with serious illness and nearing the end of life will find exactly what their organization needs in the second edition of the acclaimed Sourcebook by Dr. Joanne Lynn and her colleagues. Improving Care for the End of Life provides expert guidance on how to make significant improvements now, at all levels of the health care system-from the bedside and the hospital to the health care policy and legislative arenas-by using the rapid cycle approach to change. The ideas are proven, and the stories of teams that have put them to use will inspire and enlighten.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Susan A Jessell, MSN,CRNP,ACHPN(Western Pennsylvania Hospital)
Description: First published in 2000, this is a sourcebook for organizations interested in improving end of life care. From instruction in the rapid cycle approach to quality improvement to tips on getting things started, this book is a wealth of information on specifically what can be done to improve end of life care in many different patient populations.
Purpose: The purpose is to give readers the best available advice on how to make improvements in the healthcare systems in which they work. The book does this through examples of models of programs across the country including a compendium of resources and samples of data collection instruments. There are also examples of what did not work.
Audience: This book would be most helpful not only to those in end of life care looking for ways to enhance and improve existing programs, but also for those who are creating programs in palliative care or hospice. Nurse managers, administrators of home care and hospice agencies, and medical directors will find real guidance.
Features: The four parts cover quality improvement methods based on the rapid-cycle breakthrough approach with many examples of how practices were improved. The second part deals with changes that families and patients think are most important or would most benefit from. Part 3 describes the role of palliative care services and their financing with strategies for improving these areas. Part 4 addresses specific disease systems and ways to address and improve services and medical management in the patient population of Alzheimer's, end stage heart disease, dementia, and others. The list of resources at the end of each chapter is helpful. This updated edition has new chapters on continuity of care and expanded information on pain management, advanced care planning, and more.
Assessment: This is a book that will be referenced often for its innovative ideas, resources, and usable tools.
From the Publisher
"This book aims to equip readers with the best available advice on how to make substantial improvements in the health care system so that it serves the seriously ill person who is coming to the end of life. And that's just what it does. This book is the result of a year-long collaborative project, co-sponsored by the Center to Improve Care of the Dying and the Institute for Healthcare Improvement, that included more than four dozen health care organisations committed to changing practices for the sake of real quality improvement in end-of-life care. This is an excellent resource and should be required reading for anyone in palliative care who is interested in improving any aspect of the care they give to patients and families. It is well written and immensely practical. Reading it leaves you feeling motivated to get out there and do something—this week! Highly recommended."—Roger Woodruff, Director of Palliative Care, Austin & Repatriation Medical Centre, Melbourne, Australia

"The book resounds with a simple and do-able approach to getting the job done by knowing where you are and measuring improvements in specific domains. The book also includes an appendix with many valid and reliable instruments for measuring quality and standards of palliative care; tools to assess pain, spirituality, and grief; and multidimensional instruments. Improving Care for the End of Life is a sourcebook that is especially suited for managers and team leaders who are involved in end-of-life care. Others working in health care improvement will enjoy the book for its exemplification of a tried-and-true methodology for improving care."—Psychiatric Services

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Product Details

  • ISBN-13: 9780195310429
  • Publisher: Oxford University Press, USA
  • Publication date: 8/14/2007
  • Edition description: New Edition
  • Edition number: 2
  • Pages: 464
  • Product dimensions: 9.30 (w) x 6.30 (h) x 1.00 (d)

Table of Contents

Foreword Donald M. Berwick vii

Part I Overview

1 Introduction: Continuous Quality Improvement for Better End-of-Life Care 3

2 How to Make Improvement Happen 19

Part II Improved Patient Care Through Improved Practice and Systems

3 Preventing, Assessing, and Treating Pain 53

4 Managing Dyspnea and Ventilator Withdrawal 89

5 Beyond the Living Will: Advance Care Planning for All Stages of Health and Disease 105

6 Supporting People in Difficult Times: Relationships, Spirituality, and Bereavement 133

7 Continuity of Care: Improving Transitions, Continuity, and Coordination of Care in the Health Care System 163

Part III Arrangements to Promote Reform

8 Caring for the Caregivers: Helping Staff to Provide Good Care 197

9 Hospital-Based Palliative Care Consults and Units 217

10 Law, Policy, and Finance 241

Part IV Opportunities in Specific Diseases

11 Alzheimer's and Other Dementias: Opportunities to Honor Life 265

12 Opportunities to Improve Care for Cancer Patients 291

13 Offering End-of-Life Services to Patients With Advanced Heart or Lung Failure 301

14 Depression and Delirium 321

15 Conclusion: Getting Started 337

Appendix: Instruments 347

Resources 403

Glossary 415

References 425

Index 437

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