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Evaluation
Evaluating the quality of end of life care is difficult. Aspiring to evaluate outcomes for end of life care and education on a community level is even tougher, and attributing changes in those measurements to particular interventions, probably well nigh impossible.
That said, there are four measurements, under development that we hope will give us some understanding if things are changing in our community and if our efforts and the efforts of others, might be having an impact.
Advanced Directives
Santa Barbara Cottage Health Care System is able to track the numbers and percentages of patients that enter their hospitals with Advanced Directives and segment the data by zip code, age, race and sex. Focusing on Santa Barbara Cottage Hospital and Goleta Valley Cottage Hospital we will track that percentage over time in general, and monitor various segments of the data in response to particular education and outreach efforts related to advanced directives and “the conversation.”
Family Response Cards
All of the primary care providers and many skilled nursing facilities will begin to ask a shared set of questions to family members of a patient that has died while in their care. Over time, the aggregation of that data should tell us not only how individual agencies or facilities are doing, but how we, as a community, are doing in caring for the dying and their loved ones.
Assessing Feelings and Attitudes toward Death For People Directly Involved in Certain Programs
Feelings and attitudes run deep, and in many cases are unconscious. Using a construct called Terror Management Theory, we will be assessing changes in these feelings and attitudes in people that participate in specific education or experiental programs.
Assessing Feelings and Attitudes toward Death Community Wide
Using the same construct, we will conduct periodic surveys in Santa Barbara to see if we are making a dent in the community wide perspective of end of life issues.
As of Spring 2010, these evaluation tools are still very much in development. By the end of 2010 we should be able to clearly explain our evaluation methods and in some cases have baseline data.
