{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:33:04Z","timestamp":1760059984902,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>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 (\u03c72 (3, n = 138) = 9.75, p = 0.021). Exploration of patients\u2019 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.<\/jats:p>","DOI":"10.3390\/curroncol32080430","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:55:37Z","timestamp":1753872937000},"page":"430","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using Audit to Improve End-of-Life Care in a Tertiary Cancer Centre"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8938-8481","authenticated-orcid":false,"given":"Conor D.","family":"Moloney","sequence":"first","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3052-3975","authenticated-orcid":false,"given":"Hailey K.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Marymount University Hospital and Hospice, T12 A710 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9907-5680","authenticated-orcid":false,"given":"Daniel","family":"Nuzum","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"},{"name":"Marymount University Hospital and Hospice, T12 A710 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mairead","family":"Lyons","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard M.","family":"Bambury","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"},{"name":"Cancer Research@UCC, University College Cork, T12 XF62 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dearbhaile C.","family":"Collins","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"},{"name":"Cancer Research@UCC, University College Cork, T12 XF62 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rois\u00edn M.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"},{"name":"Cancer Research@UCC, University College Cork, T12 XF62 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"O'Donovan","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renelyn","family":"Sumugat","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahid","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinead A.","family":"Noonan","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"},{"name":"Cancer Research@UCC, University College Cork, T12 XF62 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek G.","family":"Power","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"},{"name":"Cancer Research@UCC, University College Cork, T12 XF62 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aoife C.","family":"Lowney","sequence":"additional","affiliation":[{"name":"Marymount University Hospital and Hospice, T12 A710 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2887-7336","authenticated-orcid":false,"given":"Seamus","family":"O\u2019Reilly","sequence":"additional","affiliation":[{"name":"Cork University Hospital, Wilton, T12 DC4A Cork, Ireland"},{"name":"Cancer Research@UCC, University College Cork, T12 XF62 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Jane","family":"O'Leary","sequence":"additional","affiliation":[{"name":"Marymount University Hospital and Hospice, T12 A710 Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"ref_1","unstructured":"Central Statistics Office (2024). Vital Statistics Yearly Summary: 2023, Central Statistics Office. Available online: https:\/\/www.cso.ie\/en\/releasesandpublications\/ep\/p-vsys\/vitalstatisticsyearlysummary2023\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/nrclinonc.2015.201","article-title":"Integrating palliative care into the trajectory of cancer care","volume":"13","author":"Hui","year":"2016","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_3","first-page":"606","article-title":"Associations between palliative-care consultations and end-of-life quality in cancer patients\u2019 last 6 months","volume":"32","author":"Chen","year":"2024","journal-title":"Support. Care Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.jpainsymman.2024.01.029","article-title":"Specialist palliative care use and end-of-life care in patients with metastatic cancer","volume":"67","author":"Hua","year":"2024","journal-title":"J. Pain Symptom Manag."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Carroll, H.K., Broderick, A., McCarthy, O., Bambury, R.M., Power, D.G., Collins, D.C., Connolly, R.M., Noonan, S.A., Collins, D., and Cunningham, E. (2023). 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.","DOI":"10.1177\/00302228231196620"},{"key":"ref_6","unstructured":"Neuberger, J., Guthrie, C., and Aaronovitch, D. (2025, May 12). More Care, Less Pathway: A Review of the Liverpool Care Pathway, Available online: https:\/\/www.gov.uk\/government\/publications\/review-of-liverpool-care-pathway-for-dying-patients."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Parker, K.E., Gerken, K., Huckaby, A.P., Gutek, A., Freytag, A., Buderer, N., Rice, M.R., Craig, M.E., Cacciotti, M., and Stausmire, J.M. (2025). Collaboration of an Obstetrical Residency Program With a Community Hospice\/Bereavement Agency to Implement an Obstetrician Specific Educational Curriculum to Improve Care to Bereaved Families and Support Staff During Difficult Delivery Situations. Am. J. Hosp. Palliat. Med.","DOI":"10.1177\/10499091251334636"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.3332\/ecancer.2024.1822","article-title":"Palliative and end-of-life care initiatives for people dying from cancer in India: A narrative review","volume":"18","author":"Salins","year":"2024","journal-title":"Ecancermedicalscience"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1017\/S1478951523001463","article-title":"The quality of death and dying of patients with advanced cancer in hospice care in Uganda and Kenya","volume":"22","author":"Goombs","year":"2024","journal-title":"Palliat. Support. Care"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Shutoh, M., Morita, T., Aoyama, M., Kizawa, Y., Shima, Y., and Miyashita, M. (2025). Congruence between preferred and actual place of death and its association with quality of death and dying in advanced cancer patients: A nationwide survey in Japan. PLoS ONE, 20.","DOI":"10.1101\/2025.02.22.25322724"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Lin, H., Ni, P., Wu, B., Liao, J., and Fu, J. (2024). The congruence between the preferred and actual places of death among terminal cancer patients in China. Front. Psychol., 15.","DOI":"10.3389\/fpsyg.2024.1382272"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1177\/02692163251344133","article-title":"Disparity in health care in end-of-life among patients with lung cancer and pre-existing mental disorders: A nationwide cohort study","volume":"39","author":"Videbech","year":"2025","journal-title":"Palliat. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100414","DOI":"10.1016\/j.jcpo.2023.100414","article-title":"Impact of the COVID-19 pandemic on cancer care in Ireland\u2013Perspectives from a COVID-19 and Cancer Working Group","volume":"36","author":"Carroll","year":"2023","journal-title":"J. Cancer Policy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e70221","DOI":"10.1111\/hex.70221","article-title":"Announcements of Death During the COVID-19 Pandemic: A Qualitative Study of Family Experiences","volume":"28","author":"Avazeri","year":"2025","journal-title":"Health Expect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/08258597231170836","article-title":"Cancer decedents\u2019 hospital end-of-life care documentation: A retrospective review of patient records","volume":"40","author":"Russell","year":"2025","journal-title":"J. Palliat. Care"},{"key":"ref_16","unstructured":"Coughlan, H., Keegan, O., and Time to Reflect: National Survey Findings (2025, May 12). Dublin, Ireland: Irish Hospital Foundation. Available online: https:\/\/hospicefoundation.ie\/our-supports-services\/advocacy-research\/research\/time-to-reflect\/."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e3038","DOI":"10.1136\/bmjspcare-2021-003481","article-title":"Help for non-specialists assessing EOLC","volume":"14","author":"Miller","year":"2022","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S887","DOI":"10.1016\/j.annonc.2023.09.794","article-title":"1579P Improving in-hospital end-of-life care (EOLC) for oncology patients in a tertiary cancer centre","volume":"34","author":"Moloney","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"26323524221128838","DOI":"10.1177\/26323524221128838","article-title":"Improving the quality of family meeting documentation in the ICU at the end of life","volume":"16","author":"Kennedy","year":"2022","journal-title":"Palliat. Care Soc. Pract."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3400","DOI":"10.1002\/cncr.34400","article-title":"Goals of care documentation by medical oncologists and oncology patient end-of-life care outcomes","volume":"128","author":"Epstein","year":"2022","journal-title":"Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1001\/archinternmed.2012.2364","article-title":"Factors important to patients\u2019 quality of life at the end of life","volume":"172","author":"Zhang","year":"2012","journal-title":"Arch. Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e553","DOI":"10.1093\/oncolo\/oyad269","article-title":"Improved symptom change enhances quality of dying in patients with advanced cancer: An East Asian cross-cultural study","volume":"29","author":"Huang","year":"2024","journal-title":"Oncologist"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1080\/02813432.2024.2346131","article-title":"Cancer patients have a reduced likelihood of dying in hospital with advance care planning in primary health care and a summarizing palliative plan: A prospective controlled non-randomized intervention trial","volume":"42","author":"Driller","year":"2024","journal-title":"Scand. J. Prim. Health Care"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Karim, A., Thakur, P., Ramani, D.P., Fernandes, D., Miriyala, R., Vadgaonkar, R.A., and Viswanath, V. (2025). An Audit Cycle to Evaluate the Improvement in Documentation of Breathlessness and Non-Pharmacological Interventions in Palliative Care Services. Indian J. Palliat. Care, 1\u20135.","DOI":"10.25259\/IJPC_344_2024"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1089\/jpm.2024.0007","article-title":"Spiritual care in palliative medicine and end of life: A bibliometric network analysis","volume":"28","author":"Losiggio","year":"2025","journal-title":"J. Palliat. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1089\/jpm.2022.0051","article-title":"Effectiveness of training programs about a palliative care approach: A systematic review of intervention trials for health care professionals","volume":"26","author":"Bainbridge","year":"2023","journal-title":"J. Palliat. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100623","DOI":"10.1016\/j.esmoop.2022.100623","article-title":"Effects of a communication training for oncologists on early addressing palliative and end-of-life care in advanced cancer care (PALLI-COM): A randomized, controlled trial","volume":"7","author":"Harnischfeger","year":"2022","journal-title":"ESMO Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e862","DOI":"10.1136\/bmjspcare-2019-001954","article-title":"Palliative and end-of-life care and junior doctors: A systematic review and narrative synthesis","volume":"12","author":"Bharmal","year":"2019","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tan, S.Y., Tan, J.R., Ong, Y.T., Ng, Y., Sinnathamby, A., Abdul Hamid, N.A., Ong, S.Y., and Krishna, L.K. (2025). The impact of death and dying on surgeons in a tertiary cancer centre in Singapore. BMC Surg., 25.","DOI":"10.1186\/s12893-025-02881-1"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1038\/s41579-021-00639-z","article-title":"Infectious disease in an era of global change","volume":"20","author":"Baker","year":"2022","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100410","DOI":"10.1016\/j.jcpo.2023.100410","article-title":"Climate toxicity: An increasingly relevant clinical issue in Cancer Care","volume":"35","author":"Weadick","year":"2023","journal-title":"J. Cancer Policy"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjspcare-2021-002973","article-title":"End-of-life care in natural disasters including epidemics and pandemics: A systematic review","volume":"13","author":"Kelly","year":"2021","journal-title":"BMJ Support. Palliat. Care"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/8\/430\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:18:54Z","timestamp":1760033934000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/8\/430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["curroncol32080430"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32080430","relation":{},"ISSN":["1718-7729"],"issn-type":[{"type":"electronic","value":"1718-7729"}],"subject":[],"published":{"date-parts":[[2025,7,30]]}}}