Supporting Evidence. These indicators are based on the definitions and constituents of a “good death” described above. These studies demonstrate that aspects of care near death should focus on symptoms, mood, spirituality and completion, bereavement, and the needs of survivors. There is consensus among many bodies that these aspects of care for dying patients must be improved (3,13,23,36,58 - 60). This subgroup of quality indicators targets in the final week of life—patients who are expected to die. One of the challenges of using medical records to measure care provided to dying patients is the difficulty in using chart documentation to prospectively identify patients who will die. For a patient dying an “expected death,” the medical record contains explicit documentation more than 1 day before death that the patient is expected to die in a short period or that the patient is not expected to survive to hospital discharge. Physician, nurse, social worker, and pastoral care notes may contain such documentation, which also includes information about bereavement counseling, religious rites, and postmortem arrangements.