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. 2025 Jul 30;32(8):430.
doi: 10.3390/curroncol32080430.

Using Audit to Improve End-of-Life Care in a Tertiary Cancer Centre

Conor D Moloney  1 , Hailey K Carroll  1 , Elaine Cunningham  2 , Daniel Nuzum  1   2 , Mairead Lyons  1 , Richard M Bambury  1   3 , Dearbhaile C Collins  1   3 , Roisín M Connolly  1   3 , Paula O'Donovan  1 , Renelyn Sumugat  1 , Shahid Iqbal  1 , Sinead A Noonan  1   3 , Derek G Power  1   3 , Aoife C Lowney  2 , Seamus O'Reilly  1   3 , Mary Jane O'Leary  2
Affiliations

Using Audit to Improve End-of-Life Care in a Tertiary Cancer Centre

Conor D Moloney et al. Curr Oncol. .

Abstract

High-quality end-of-life care (EoLC) is a critical yet often underemphasised component of oncology care. Several shortcomings in the delivery of EoLC for oncology patients in our centre during the COVID-19 pandemic were identified in our initial 2021 audit. In 2022, we introduced a care of dying patients proforma, an EoLC quality checklist, targeted education and training for staff, and an expanded end-of-life (EoL) committee. This re-audit aimed to review how these changes impacted on the care received by patients in a tertiary cancer centre. A second retrospective re-audit of patients who died between 11 July 2022 and 30 April 2023 was performed to assess quality of EoLC using the Oxford Quality indicators. A total of 72 deaths occurred over the audit period. Quality of EoLC improved significantly when compared to the initial audit (χ2 (3, n = 138) = 9.75, p = 0.021). Exploration of patients' wishes was documented in 48.8% and referral to pastoral care was documented in 68.3%, from 24.2% and 10.6%, respectively. The proportion of patients receiving poor EoLC reduced from 21.2% to 8.3%. Our study demonstrates the benefits of simple interventions, the importance of re-audit, and the role of ongoing interdisciplinary commitment to improving EoLC for our patients.

Keywords: audit; cancer; end-of-life care (EoLC); oncology; palliative care; quality improvement.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure A1
Figure A1
CUH Care of the Dying Patient Guidance proforma.
Figure 1
Figure 1
Oxford Quality indicators for mortality review.
Figure 2
Figure 2
Documentation of domains of EoLC pre- and post-intervention.
See this image and copyright information in PMC

References

    1. Central Statistics Office . Vital Statistics Yearly Summary: 2023. Central Statistics Office; Dublin, Ireland: 2024. [(accessed on 12 May 2025)]. Online ISSN 2009-5333. Available online: https://www.cso.ie/en/releasesandpublications/ep/p-vsys/vitalstatisticsy...
    1. Hui D., Bruera E. Integrating palliative care into the trajectory of cancer care. Nat. Rev. Clin. Oncol. 2016;13:159–171. doi: 10.1038/nrclinonc.2015.201. - DOI - PMC - PubMed
    1. Chen S.T., Chen S.C., Lee H.J., Chen C.H. Associations between palliative-care consultations and end-of-life quality in cancer patients’ last 6 months. Support. Care Cancer. 2024;32:606. doi: 10.1007/s00520-024-08814-7. - DOI - PubMed
    1. Hua M., Guo L., Ing C., Lackraj D., Wang S., Morrison R.S. Specialist palliative care use and end-of-life care in patients with metastatic cancer. J. Pain Symptom Manag. 2024;67:357–365. doi: 10.1016/j.jpainsymman.2024.01.029. - DOI - PMC - PubMed
    1. Carroll H.K., Broderick A., McCarthy O., Bambury R.M., Power D.G., Collins D.C., Connolly R.M., Noonan S.A., Collins D., Cunningham E., et al. Room to Improve: An Audit of In-Hospital End-of-Life Care for Oncology Patients in a Tertiary Cancer Centre in Ireland During the COVID-19 Pandemic. OMEGA-J. Death Dying. 2023 doi: 10.1177/00302228231196620. - DOI - PubMed

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