Different instruments ought to look at important sentinel time periods throughout the illness course to ensure quality medical care. Nearly one in three patients are unable to be interviewed in the last week of life. To simply disregard their experience would miss important information on the quality of medical care. Yet, a proxy is only able to report on their observations or perceptions of the quality of care. Family members are often more critical and provide an important perspective that can lead to improving the quality of care.
Research is needed to understand who can best serve as the respondent.
Such research is needed to design valid instruments. Each have their own costs and limitations regarding accuracy of the data. Research ought to seek to determine the most cost effective means to get reliable and valid indicators of quality medical care. Research is needed to examine the degree to which the wording and the location of questions influence the respondents' views. Total survey design that employs cognitive interviews is important to understand the process undertaken by respondents in answering survey questions.