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Bereavement, Diffusion of innovation, Palliative care, Quality improvement, System archetypes, Systems thinking



  1. Jenko, Mimi DNP, RN, CHPN, PMHCNS-BC
  2. Short, Nancy M. DrPH, MBA, RN


Bereavement services for families are an established part of hospice and palliative care. However, patients also die in the acute care and long-term care environments. Often, hospice is not involved, creating a potential gap in care. This article recounts a journey to improve care for all families of deceased patients, despite the presence or absence of hospice. A palliative care clinical nurse specialist led a quality improvement team, which used a systems thinking approach to develop and implement a downloadable bereavement booklet for families. Expected and unexpected outcomes are discussed for this replicable project.