Quality Indicator Repository

The Hospice Care Index (or HCI) is an index measure; it scores hospices on a 0 to 10 scale using ten Medicare claims-based indicators which capture a broad array of information on hospice service provision. The HCI provides information that reflects care processes during a hospice stay and allows patients, families, and caregivers to make informed decisions. Collectively these indicators represent different aspects of hospice service and thereby characterize hospices comprehensively, rather than on just a single care dimension. Each indicator equally affects the single HCI score, reflecting the equal importance of each aspect of care delivered from admission to discharge.

This summary indicator includes 5 questions covering families and others needs, emotional, practical, spiritual, religious and cultural support and being informed about the patient's condition and treatment. All questions include response options on a 5-point Likert-scale (Strongly agree, Agree, Neither agree not disagree, Disagree, Strongly disagree or N/A/Not sure). Questions include: I was asked about my needs; I was given enough emotional help and support by staff; I was given enough practical support (for example with finding refreshments and parking arrangements); I was given enough spiritual/religious/cultural support; I was kept well informed and had enough opportunity to discuss their condition and treatment with staff.

When you consider all aspects of your life—physical, psychological, social, spiritual, existential, and financial—your quality of life over the past 2 days was:(very bad) 0 ———————— 10 (excellent).

Individual survey item included as part of the CAHPS® Hospice Survey asking respondents: "Using any number from 0 to 10, where 0 is the worst hospice care possible and 10 is the best hospice care possible, what number would you use to rate your family member's hospice care?" Response options are on a 0-10 rating scale, with 0=Worst hospice care possible and 10=Best hospice care possible.

This staff-reported summary measure includes 11 questions regarding staff confidence in delivering end of life care: I am confident I can recognise when a patient might be dying imminently (within hours to days); I feel confident in my skills to communicate clearly and sensitively to dying patients and those important to them; I am confident I have the skills to involve the dying patient and those important to them in decisions about end of life care in line with their wishes and preferences; I know how to access specialist palliative care advice, if required, when addressing specific end of life care needs for dying patients; I know how to respond to requests to die outside of the hospital setting from dying people and/or those important to them; I feel confident to respond to the practical and social needs of the dying person; I feel confident to respond to the spiritual, emotional and cultural needs of the dying person; I am confident in my ability to discuss hydration options with dying patients and those important to them; I am confident in assessing and managing patient pain and physical symptoms at the end of life; I feel confident to respond to the practical and social needs of those important to the dying person; I feel confident to respond to the spiritual, emotional and cultural needs of those important to the dying person.