End-of-life preferences in advanced cancer patients willing to discuss issues surrounding their terminal condition

Source: European Journal of Cancer Care

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Date of publication: April 2012

Publication type: Article

In a nutshell: The aim of the study is to describe end-of-life preferences of advanced cancer patients willing to talk about death issues. Eighty-eight advanced cancer patients were interviewed through End of Life Preferences Interview (ELPI), a 23-item interview covering a wide range of end-of-life care issues. Most interviewed subjects were home care patients. The article concludes that ELPI can be a useful instrument to adapt the model of care to the specific needs and values of each patient.

Some important notes: This article is only available online at present. For assistance in obtaining a copy of this article, please contact your local NHS Library. Follow this link to find your local NHS Library.

 

Focusing on the needs of older carers at the end of life

Source: National End of Life Care Programme

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Date of publication: March 2012

Publication type: Case study

In a nutshell:  A joint initiative which began in August 2010 between the Department of Health and Age UK aims to support older carers of people at the end of life so that preferred place of care and preferred place of death are achieved. Carers practical and emotional needs are addressed. The project includes the development of a toolkit which will be available to other organisations who wish to use this model.  The final report will be available in September 2013.

Length of publication: 1 webpage

Acknowledgement: National End of Life Care Programme

Palliative and end of life rapid discharge pathway

Source: National End of Life Care Programme

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Date of publication: March 2012

Publication type: Case study

In a nutshell: In 2009 the University Hospital of North Staffordshire introduced a palliative and end of life rapid discharge pathway for patients in or approaching the terminal phase of their illness.  Discharge is arranged at the earliest opportunity, usually within days or hours.  It is already having a significant impact with around 45 patients a quarter discharged in this way. Unanticipated benefits include the development of strong working relationships between secondary and primary care,  new services being developed and the development of the role of clinical champions for every clinical area who help spread good practice (there are 50 at present).

Length of publication: 1 webpage

Acknowledgement: National End of Life Care Programme

Anticipatory care planning and integration: A primary care pilot study aimed at reducing unplanned hospitalization

Source: British Journal of General Practice, 2012, 62, (595) (e113-e120)

Date of publication: February 2012

Publication type: Article

In a nutshell: This article reviews a pilot study in Scotland which aimed to provide anticipatory care plans (ACPs) for patients who were at risk of hospital admission. Patients’ wishes in the event of sudden deterioration in their health were recorded.  The pilot achieved statistically significant reductions in unplanned hospitalisation for patients with multiple morbidities and  demonstrates the potential for providing both better care as well as better value for health and social care services.

Length of publication: 8 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Acknowledgement: Embase

Blackpool Rapid Discharge Pathway: Case Study on National End of Life Programme website

Source:  National End of Life Care Programme website

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Date of publication: February 2012

Publication type: case study

In a nutshell: Outling the successful  impact of a two-level rapid discharge pathway.  Between November 2009 and September 2011, 166 people were discharged via the fast-track process (that is, within 24 hours), and a  further 32 people were discharged through the four hour process.

Acknowledgement: National End of Life Care Programme

A narrative literature review of the evidence regarding the economic impact of avoidable hospitalizations amongst palliative care patients in the UK

Source:  Progress in Palliative Care, 19, (6), p291-298.

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 Date of publication:  November 2011

Publication type:  article

In a nutshell:  This article provides a narrative review of evidence relating to the potential economic impact of reducing avoidable admissions among palliative care patients in the UK.  A search for evidence on the economic consequences of avoidable hospital admissions among palliative care patients was conducted, and five studies met the inclusion criteria.  The limited evidence showed that avoidable readmission rates are high. The full economic consequences of reducing readmissions however, has not been addressed.  The authors call for more evidence with a focus on the economic implications for community care versus acute care.

Length of publication:  8 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Acknowledgement:  EMBASE

Environments for care at the end of life – The King’s Fund’s Enhancing the Healing Environment Programme 2008-2010

Source: King’s Fund

Follow this link to download a copy of this report

Date of publication: August 2011

Publication type: Report

In a nutshell:  The King’s Fund’s Enhancing the Healing Environment (EHE) programme encourages and enables nurse-led teams to work in partnership with patients to improve the environment in which to deliver care.This publication describes projects in 19 NHS trusts and one HM prison where improvements were made to the environment of care at the end of life.

Length of publication: 96 pages

 

Achieving the preferred place of care for hospitalized patients at the end of life

Source: Palliative Medicine June 2011 v.25(4) p333-336

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Date: June 2011

Publication type: Article

Publication length: 4 pages

In a nutshell: The Department of Health end-of-life strategy contains a number of quality markers which include taking into account patients’ wishes for their final place of care. An audit was conducted on discussion of preferred place of care (PPC) for all patients referred to the hospital palliative care team who died during the audit period. The data highlighted the need to distinguish between preferred place of care and preferred place of death. Patients’ wishes regarding PPC change as death approaches. A greater number of patients wished to die in hospital than was expected.

Some important notes: Contact your local health library for a copy of this article. Follow this link to find your local health library.

Spreading best practice in dementia and end of life care

Source:  Advancing Quality Alliance

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Date of publication:  April 2011

Publication type:  Case Study

In a nutshell:   Led by Greater Manchester and Cheshire Palliative Care Network, this project aims to build on existing end of life care tools such as the Gold Standard Framework and the Liverpool Care Pathway.  The objective is to provide sets of tools that equip GP and out-of-hours providers to make better decisions about end of life care for dementia suffers which will result in the provision of more appropriate care and significant cost savings. 

Length of publication: 2 pages

A retrospective analysis of preferred and actual place of death for hospice patients.

 Source:  International Journal of Palliative Nursing  2010, 16 (9) p.424-30 

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Date of publication: September 2010

Publication type: Article

In a nutshell:  Research comparing the preferred and actual place of death of hospice patients. The article focussed on results of a retrospective analysis of patients’ records over a 6-month period and on possible reasons why some patients’ preferences were not recorded. The suitability of preferred place of death as an outcome measure in quality evaluations of palliative care services is considered and recommendations made.

Length of publication: 7 pages

Some important notes:  This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library

Acknowledgement: BNI

Achieving a good death for all.

Source: British Medical Journal, September 2010,  341(7774) p.656-8

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Date of publication: September 2010

Publication type: Article

In a nutshell: Palliative Care Beyond Cancer. This article discusses best practice to improve quality of care for the last days of life. The Liverpool Care Pathway is discussed along with the Marie Curie Palliative Care Institute report ‘National Care of the Dying Audit of Hospitals in England’ (2009). Patients’ wishes regarding place of death and financial implications from the National Audit Office are considered.

Length of publication: 2 pages

This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library

Advance care planning ensures patient choice on place of death

Source: Nursing Times, October 2010, 106(40) p8

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Publication type: Article

In a nutshell: Comments about the role of advance care planning in ensuring that patients’ wishes regarding the place of their end-of-life care and death are respected. The success of Preferred Priorities for Care in NHS West Essex PCT is discussed.

Length of publication: 1 page

This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library

The Government’s eight-point plan for improving end-of-life care

Source: British Journal of Nursing, 2010, 19(18) p1194-6

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Date of publication: October 2010

Publication type: Article

In a nutshell: Following recommendations made in the Department of Health’s 2nd annual report of the ‘End of life care strategy’ (2010). This article evaluates of the use of personal health budgets, changing public opinion towards death, delivery of care in the last days of life, care in different settings and other measures to improve care for people who are dying.

Length of publication: 3 pages

This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library

Using prognostic indicator guidance to plan care for final stages of life

Source: Primary Health Care

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Date of publication: July 2010

Publication type: Article

In a nutshell: The author describes how clinicians and healthcare providers could improve predictions of patients needs as they near the end of their lives by using  prognostic indicator guidance.   Primary care teams along with care homes and hospitals that use this method of identification, assessment and planning find it much easier to provide top quality proactive care where it is most needed.  They also find they are better able to adhere to patients’ wishes and avert crises as well as reducing inappropriate hospital admissions and hospital deaths.

Length of publication: 4 pages.

Some important notes: This article is available in full text with an NHS Athens account.  If you do not have an NHS Athens account please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.