Sterben im Krankenhaus und hospizfreundliche Krankenhäuser. Reflexionen aus Irland

The chapter assesses the quality of care provided by Irish hospitals in the last week of life. It is based on the results of a project funded by the Hospice-friendly Hospitals Programme (2007-2012) and contributes to the growing practice within the Irish hospital system of auditing performance against standards in order to ensure that every aspect of its work meets, and even exceeds, the highest standards of care and excellence. The chapter addresses a number of questions, the first of which is "how good are the care outcomes for patients who die in Irish hospitals compared to hospitals elsewhere?" The second is "which care inputs have a significant and substantial influence on care outcomes?" The third is: "how can the findings be used to improve the quality of end-of-life care in Irish hospitals?" In order to answer these questions, data were collected from nurses, doctors and relatives who spent the most time with a sample of 1,000 patients during their last week of life. Each hospital completed the audit on a random sample of 50 deaths in the four month period between November 2008 and February 2009. As a proportion of total deaths in Ireland in 2008, this is a representative sample of 10% of acute hospital deaths and 29% of community hospital deaths. The research was carried out in 24 acute hospitals which constitute three quarters of the acute hospital sector in Ireland. Data collection was also completed in 19 community hospitals which represents 20% of community hospital beds in the country.