<s>[INST] I am curious, how hospitalists improve, refine, or modify their end-of-life care with feedback and assessment tools. 

While hospitalists are often skilled in working with hospital-specific quality improvement projects aimed at reducing length of stay, readmissions, and improving patient satisfaction, they may face challenges when implementing or integrating quality improvement projects focused on end-of-life care. Common barriers might include lack of time, conflicting priorities, and variation in education and training. However, these challenges also provide opportunities for growth. In this area, hospitalists can put into practice strategies for obtaining and utilizing feedback to improve care of this important population. 

Hospitalists can solicit feedback through post-discharge surveys of patients and their families, peer review, review of audits and mortality reviews, or derivation of data from electronic health records. They might leverage this feedback to revamp hospital policies or modify end-of-life protocols, improve communication around dying, facilitate care that honors the wishes and preferences of patients dying in the hospital, or develop specific curriculum aimed at training physicians in discussing end-of-life care. Every component of care can be fine-tuned: offerings by pastoral care services; equitable care for multicultural populations; the incorporation of discussions about psychosocial perspective of family grief needs. 

How does educational curriculum play a role in developing key competencies in providing end-of-life care?[/INST]