Inpatient Hospice Transitions Checklist

Usability: Clinician-reported ease of use and usability of the I-HTC, assessed using the System Usability Scale.

The SU scale is generally used after the respondent has had an opportunity to use the system being evaluated, but before any debriefing or discussion takes place. Respondents should be asked to record their immediate response to each item, rather than thinking about items for a long time. SUS yields a single number representing a composite measure of the overall usability of the system being studied. Note that scores for individual items are not meaningful on their own. To calculate the SUS score, first sum the score contributions from each item. Each item's score contribution will range from 0 to 4. For items 1,3,5,7,and 9 the score contribution is the scale position minus 1. For items 2,4,6,8 and 10, the contribution is 5 minus the scale position. Multiply the sum of the scores by 2.5 to obtain the overall value of SU.

Proportion of participating PLWD who enroll in hospice, determined through EHR review.

(Investigator Initiated) - This brief questionnaire focused on surrogate-reported understanding of hospice services and their role in supporting the person living with dementia. The six-item Hospice Understanding Assessment will measure surrogate decision-makers' self-reported understanding of hospice care following clinician-led discussions. Each item is rated on a 5-point Likert scale, with total scores ranging from 6 to 30. Higher scores indicate greater perceived understanding of hospice eligibility, services, care options, and confidence in decision-making. Mean scores and standard deviations will be calculated, and individual item responses will be examined to identify areas of limited understanding. Scores will be interpreted descriptively, as the assessment does not have established clinical cutoffs.

Satisfaction with care, assessed using the FAMCARE scale.

The original 20-item FAMCARE scale will assess surrogate decision-makers' satisfaction with care provided to their family member. Each item is rated on a 5-point Likert scale ranging from 1 (Very satisfied) to 5 (Very dissatisfied). Responses will be reverse-coded and summed to generate a total score ranging from 20 to 100, with higher scores indicating greater satisfaction with care. Mean scores, standard deviations, and individual item responses will be examined descriptively to evaluate overall satisfaction and identify areas for improvement in care delivery and communication.

Quality of communication: Surrogate-reported quality of clinician-surrogate communication, assessed using the Quality of Communication questionnaire.

The Quality of Communication (QOC) Questionnaire, developed by Engelberg et al. (2006), assesses perceived quality of clinician communication using 13 items across two subscales: general communication skills (6 items) and end-of-life communication (7 items). Each item is rated on an 11-point scale ranging from 0 (Worst imaginable) to 10 (Best imaginable). Subscale scores are calculated as the mean of the corresponding item ratings, with higher scores indicating better perceived communication quality.