Using Audit to Improve End-of-Life Care in a Tertiary Cancer Centre †

  • Conor D. Moloney
  • , Hailey K. Carroll
  • , Elaine Cunningham
  • , Daniel Nuzum
  • , Mairead Lyons
  • , Richard M. Bambury
  • , Dearbhaile C. Collins
  • , Roisín M. Connolly
  • , Paula O’Donovan
  • , Renelyn Sumugat
  • , Shahid Iqbal
  • , Sinead A. Noonan
  • , Derek G. Power
  • , Aoife C. Lowney
  • , Seamus O’Reilly
  • , Mary Jane O’Leary

Research output: Contribution to journalArticlepeer-review

Abstract

High-quality end-of-life care (EoLC) is a critical yet often underemphasised component of oncology care. Several shortcomings in the delivery of EoLC for oncology patients in our centre during the COVID-19 pandemic were identified in our initial 2021 audit. In 2022, we introduced a care of dying patients proforma, an EoLC quality checklist, targeted education and training for staff, and an expanded end-of-life (EoL) committee. This re-audit aimed to review how these changes impacted on the care received by patients in a tertiary cancer centre. A second retrospective re-audit of patients who died between 11 July 2022 and 30 April 2023 was performed to assess quality of EoLC using the Oxford Quality indicators. A total of 72 deaths occurred over the audit period. Quality of EoLC improved significantly when compared to the initial audit (χ2 (3, n = 138) = 9.75, p = 0.021). Exploration of patients’ wishes was documented in 48.8% and referral to pastoral care was documented in 68.3%, from 24.2% and 10.6%, respectively. The proportion of patients receiving poor EoLC reduced from 21.2% to 8.3%. Our study demonstrates the benefits of simple interventions, the importance of re-audit, and the role of ongoing interdisciplinary commitment to improving EoLC for our patients.

Original languageEnglish
Article number430
JournalCurrent Oncology
Volume32
Issue number8
DOIs
Publication statusPublished - Aug 2025

Keywords

  • audit
  • cancer
  • end-of-life care (EoLC)
  • oncology
  • palliative care
  • quality improvement

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