Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE...
-
Upload
jared-williams -
Category
Documents
-
view
217 -
download
2
Transcript of Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE...
![Page 1: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/1.jpg)
Title slideEnd of Life Care
At the West Suffolk Hospital
Sam Hobson
Dr Rosemary Wade
END OF LIFE CARE PATHWAY
E
![Page 2: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/2.jpg)
End of Life Care
• National Strategy, July 2008• Builds on NICE Supportive and Palliative Care Guidance
2003
• Drivers for change– Patients want to die at home and not in hospital– We can not afford to have patients in hospital who
don’t need or want to be here
![Page 3: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/3.jpg)
More patients dying at home
• How do we make this happen?
• Identify early – well before ‘last days’• Fully inform patients and their families• Advanced care planning• Communicate patients preferences and wishes to primary
care team
![Page 4: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/4.jpg)
Which patients ?
• Patients who are likely to be in their last year of life• Either know on admission (GP - GSF) or diagnosed
during admission• Likely to have
– Advanced cancer– Advanced heart, renal, respiratory failure– Advanced neurological conditions – Multiple co morbidity (frail elderly)
![Page 5: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/5.jpg)
GPs now use, GSF – Gold Standard Framework
• Register of patients in last 6-12 months • All GP practices – QOF points• MDT meeting every 6-8 weeks• Patients’ needs discussed and care planned• Therefore inform GPs and refer to community nurses
![Page 6: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/6.jpg)
WSH End of Life Care Pathway
Identify Assess Address Communicate
![Page 7: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/7.jpg)
Identify Assess Address Communicate
• Patients who are likely to be in their last year of life• Either
– Known on admission (GP GSF)– Diagnosed during admission
• HISS – End of Life Care Alert - EOLC• EPRO – End of Life Care alert
![Page 8: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/8.jpg)
Identify Assess Address Communicate
• On and during admission a full medical, nursing and occupational therapy assessment involving patients family and carers.
• Social and occupational needs• Psychological well-being• Spiritual well-being and life goals
• Often admission process sufficient
![Page 9: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/9.jpg)
Identify Assess Address Communicate
• Consider physical, social, psychological, spiritual and information needs.
• Make clinical decisions appropriate for prognosis.• Give patient (and family) the information they need to
take a full part in deciding their priorities for their care• Consider referral to:
– In hospital - palliative care team, chaplaincy team, AHPs, specialist discharge planning etc
– On discharge – Specialist palliative care providers, social services, carer support, community AHPs etc
![Page 10: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/10.jpg)
Identify Assess Address Communicate
• To primary care on discharge– EPRO discharge letter, all letters
• To family and friends if dying– Care of the Dying Pathway LCP– Into bereavement
![Page 11: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/11.jpg)
Identify Assess Address Communicate
• On discharge always send
– EPRO End of Life Care discharge letter - A detailed discharge summary including information on patient’s diagnosis, prognosis, understanding of condition and preferences for care.
– Single point of access referral to District Nurses for palliative care assessment
![Page 12: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/12.jpg)
Care of the Dying LCP Vs 12
• Integrated care pathway used at the bed side to document care given to patients in their last hours and days of life.
• Version 12 – to address concerns regarding nutrition and hydration and regular review – contains information leaflet for patients/relatives
![Page 13: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/13.jpg)
End of Life Care Intranet pages
• New site• Main pages
– Pathway, Identify, Assess, Address, Communication• Additional pages
– Care after death, WSH palliative care team, Community specialist palliative care, Resources/Links page
![Page 14: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/14.jpg)
End of Life Care Intranet pages
• Useful paperwork • To print off and use
– Discharge in last weeks checklist– Rapid discharge home to die– LCP– Preferred priorities of care document
![Page 15: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/15.jpg)
Training programme
• Sam Hobson – End of Life care PND• Roll out over next year• LCP Vs12 and End of Life Care to each ward• Governance meetings• Targeted groups
![Page 16: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/16.jpg)
West Suffolk Hospital End of Life Care Strategy
• To provide high quality care in accordance with patients wishes
• To enhance communication and co-ordination• With challenge of
– Patients with months, weeks, days and hours to live– Hospital wide – Patients in many settings, together with a range
of appropriate medical and surgical care
![Page 17: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/17.jpg)
Main messages - Doctors
• Identify patients• Make clinical decisions appropriate to prognosis • Keep patients well informed (and their families) and
support patients with their decisions• Make plans on discharge• Communicate with GPs on discharge and outpatient
letters
![Page 18: Title slide End of Life Care At the West Suffolk Hospital Sam Hobson Dr Rosemary Wade END OF LIFE CARE PATHWAY.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649eb65503460f94bbf107/html5/thumbnails/18.jpg)
Questions ???