Bereaved Family Survey
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
The purpose of this measure is to assess families´ perceptions of the quality of care that Veterans received from the VA in the last month of life. The Bereaved Family Survey consists of 19 items (17 structured and 2 open-ended). These items cover areas of care such as communication, emotional and spiritual support. Two additional items are open-ended and give family members the opportunity to provide comments regarding the care the patient received.
Numerator
The numerator is comprised of completed surveys (at least 12 of 17 structured items completed), where the global item question has an optimal response. The global item question asks "Overall, how would your rate the care that [Veteran] received in the last month of life" and the possible answer choices are: Excellent, Very good, Good, Fair, or Poor. The optimal response is Excellent.
Denominator
The denominator consists of all inpatient deaths for which a survey was completed (at least 12 of 17 structured items completed).
Exclusions
Denominator Exclusions: Deaths within 24 hours of admission (unless the Veteran had a previous hospitalisation in the last month of life); Deaths that occur in the Emergency Department (unless the Veteran had a prior hospitalisation of at least 24 hours in the last 31 days of life); Deaths that occur in the operating room; Deaths due to suicide or accidents. Additional exclusion criteria include: Veterans for whom a family member knowledgeable about their care cannot be identified (determined by the family member´s report); or contacted (no current contacts listed or no valid addresses on file); absence of a working telephone available to the family member.
Other exclusions: Veterans for whom a family member knowledgeable about their care cannot be identified (determined by family member´s report); Absence of a current address and/or working telephone number for a family member or emergency contact.; Deaths within 24 hours of admission without a prior hospitalisation of last least 24 hours in the last 31 days of life; Deaths that occur in the operating room during an outpatient procedure; Deaths due to a suicide or accident; Surveys in which less than 12 items were answered.
Use of Risk Adjustment
Risk Adjustments
None
Stratifications
The variables necessary to stratify the measure are Veterans Integrated Service Network (VISN), facility, quarter, year, outcome. Veterans Integrated Service Network is a geographic area of the country where a facility is located. Facility is the actual Veterans Affairs medical centre or affiliated community living centre where the Veteran died. Quarter is the 3 month time period in which the patient died. Year is the Veterans Affairs fiscal year (runs from Oct 1 to Sept 30). Outcome refers to whether or not a survey was completed.
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Surveys are sent to the listed Next of Kin in the medical record approximately 4-6 weeks after death of the Veteran. Next of Kins are provided with a introductory letter and a toll-free line if they wish to either opt-out or complete the survey over the telephone.
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
The Level Of Analysis is performed at Facility level and Population (Regional and State) level.
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
Partnership for Quality Measurement. (2023). Available from: p4qm.org/measures/1623
Technical Specifications
Link to Measurement Tools
NQF Measure #1623 (last endorsed 08 January 2015)