References
In-hospital end-of-life care: an appreciative analysis of bereaved family feedback
Abstract
Experience feedback data is increasingly recognised as being helpful in improving healthcare services, and in meeting patient and family needs. This end-of-life care project, based on the principles of appreciative inquiry, sought to learn from the experiences of bereaved people whose relative had died in an acute hospital setting. Informal feedback, offered during a routine telephone call, was thematically analysed and interpreted in an appreciative manner. Confirmatory representations of caring practices and behaviours were identified, categorised and disseminated in a way that enabled staff to come to know and understand end-of-life care at its best, rather than as a set of problematised events. The findings served as a benchmark for individuals and teams to assess and progress their practice reflectively. The authors conclude that staff receptiveness to informal bereaved family feedback may be enhanced by focusing on the positive qualities of end-of-life care within existing practices.
Globally, the hospital is a principal provider of care at the end of life (Organisation for Economic Co-operation and Development, 2023), and is high on the policy agenda in England as requiring innovation and reform (NHS England, 2015; Hunter, 2018; NHS England, 2023a). Understanding the experiences of service users is essential to the design of services that are person centred and responsive to people's choices and needs (NHS England/NHS Improvement, 2022).
Accordingly, attention has been paid to meaningful and compassionate engagement with bereaved people to gain personal insights into the provision of end-of-life (EoL) care (Choice in End of Life Care Programme Board, 2015; Office for National Statistics (ONS), 2015; Care Quality Commission (CQC), 2016; Marie Curie, 2021a). The lay public are highly valued and are respected as ‘experts by experience’ (CQC, 2023), with their views being a key source of data for regulatory inspections of EoL care. Not surprisingly, the known opinions and concerns of people who are dying and those important to them are at the heart of national ambitions for quality improvement and change (Leadership Alliance for the Care of Dying People (LACDP), 2014; National Palliative and End of Life Care Partnership (NPEoLCP), 2021).
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