Project Goal: To support benchmarking and quality improvement initiatives for organizations' palliative care initiatives. To answer the question of how do we know that what we are doing has improved and continues to improve care?

The Brief Modified City of Hope Patient and Bereaved questionnaires have been developed to assist care providers obtain consistent quantitative information from patients and families about their experiences as they experience palliative care. If patients and families are fortunate, you are able to provide services for several months prior to care being transferred to hospice or to the person's death. In that case, you may wish to collect information prior to implementing service and after XX time of receiving services to determine the positive affect of your services.

Obtaining this information has opened possibilities for interventions that otherwise might have been missed. It has also provided a way of assessing positive benefit of palliative care and services provided to patients and families. The forms may be used as questionnaire or interview. Both methods have been beneficial in providing information to help improve care.

Most often, the Bereaved questionnaire is mailed to family members six to 8 weeks after the death of their loved one so we have included a DRAFT sample letter that you might wish to modify for your own use.

If you wish assistance with analysis or to compare your data to the Coalition baseline data, please feel free to contact me.

Best Wishes in your very important work and ministry.

Sr. Karin Dufault, PhD, RN
Executive Director
Supportive Care Coalition:  Pursuing Excellence in Palliative Care
Phone (503) 215-5053
e-mail: Karin.Dufault@providence.org

Brief Modified City of Hope Bereaved Questionnaire
Brief Modified City of Hope Patient Questionnaire

Draft Sample Letter

Cover Letter Template

Data Entry Templates

Patient Data
Bereaved Data

Sample Data Report

Patient Sample Data
Patient Report

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