Family Evaluation of Hospice Care Survey
Tuesday, January 22, 2013
by: VNAA Education and Quality Team

Section: Quality and Educational Programming

With the passage of the Affordable Care Act in March 2010, it is now mandatory for hospices to actively measure care delivery systems and report their outcomes in a standardized form to the federal government. The ultimate goal will be public reporting so that consumers can compare the quality of care delivered by the hospice agencies in their communities.

These performance measures are not arbitrarily selected from “the top down”; the Center for Medicare and Medicaid Services (CMS) engaged hospice experts in the development of standardized measures. The National Quality Forum (NQF), a nonprofit organization based in Washington, D.C., provided the oversight and endorsement of standards that measure and report hospice quality of care. As we know, the current performance measures include NQF Pain Measure and QAPI Program Structural Measures.

Hospice care recognizes that a terminal illness affects far more than just the patient and the unit of care for hospice professionals is the patient and family—however the patient might define his family. Based on this belief, hospices have been asking bereaved family members to evaluate the hospice care provided to their loved one. Dr. Joan Teno from Brown University conducted some of the initial research supporting this belief. She and her colleagues asked bereaved family members, after the death of their loved ones, the following questions:

  • What factors influence overall satisfaction with hospice services?
  • Which processes of care were associated with greater satisfaction?
Respondents were more likely to rate “hospice services” as excellent if (a) they were regularly informed about their loved one’s condition, (b) the hospice team provided the right amount of emotional support to them, (c) the hospice team provided them with accurate information about the patient’s medical treatment, and (d) they could identify one nurse as being in charge of their loved one’s care.[1]

From this foundational research, the NQF 0208 Family Evaluation of Hospice Care (FEHC) survey was developed.  It was initially endorsed August 9, 2009 with a renewal endorsement on February 14, 2012.  Most hospice experts believe this will be a mandatory measure in the near future.

The FEHC survey is a sent to bereaved family caregivers of individuals who died while enrolled in hospice and measures family member perceptions of the quality of care provided throughout the entire length of service.  A composite score based on responses to 17 items on the survey is identified as a composite score ranging from 0 to 100.   

Download the NQF description and the survey below. If you are not already using this survey, make it an agenda item at your next Quality of Care team meeting and plan to implement it as your measurement of family satisfaction in 2013.

Bonnie Morgan, MA, RN-BC, CHPN, FPCN

Family Evaluation of Hospice Care
Quality Positioning System (QPS) Measure Description Display Information
[1]Teno, J, et al.  Caregiver Satisfaction.  Journal of Pain and Symptom Management. 2008; April. 35(4); 365-71. 
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