LIVING & DYING WELL :
ACUTE HOSPITALS SLWG
DR STAN WRIGHT, M.D. FRCP
CONSULTANT RESPIRATORY PHYSICIAN - FORTH VALLEY
CO-CHAIR ACUTE HOSPITALS SLWG
Challenge:
Develop and sustain an Acute Hospital
Palliative Care Service so that it is fully
embedded in the culture and practice of
the hospital.
Barriers:
Workload too great for Specialist Palliative Care to deliver
alone.
Generalist staff not understanding role of Specialist Palliative
Care.
Specialist Palliative Care not always comfortable with nonmalignant disease.
Hospital system already overloaded with other priorities.
Delivering education when rapid turnover of staff.
Dependent on output of other groups eg. standards, guideline
and referral criteria, assessment tools and advanced care
planning.
Co-ordinating with other strands of work eg. Scottish Patient
Safety Programme, Better Cancer Care, Better Together,
Scotland's Patient Experience Programme, Shifting balance of
care, Improvement support teams eg. LTCG & 18 week RTT.
Advantages of Palliative Care in Hospital:
58% patients die in hospital.
Better and more efficient control of symptoms.
Orchestrates well planned discharges.
Optimises investigations and drug treatment in
advanced illness.
Improves patient and family satisfaction.
Provision of education.
Eases burdens on staff.
Recommendations:
1.
For individual Boards/Hospitals.
2.
For Working Group.
Recommendations for Individual Boards/Hospitals:
1.
All Acute Hospitals should establish a Palliative Care
Programme.
. Integration into Management Structure of Hospital.
. Implementation Team.
2.
Each Hospital has a Palliative Care Education Programme.
3.
Every Hospital has an easily accessible Palliative Care
Consultation Service.
4.
There is a ward based Palliative Care Resource which is
audited including:
i) Pain Assessment system.
ii) Care Pathway for dying patients.
iii) Service Directory.
iv) DNACPR Policy.
v) A means to communicate advanced care plans.
5.
Views of patients and families should be audited.
Recommendations for Working Group:
Establish what Specialist Care Services are needed to support
Generalists.
Help develop Palliative Care Standards in Hospital.
Support NES with regard to Palliative Care Education in
Hospital.
Work with Health Board Leads.
Work with E Health on discharge documentation.
Conclusion:
A long term project.
Benefits for patients and hospitals.
Thanks:
Pam Levack (Co-Chair)
Mark Aggleton
David Gray
Liz Travers
Tom McCarthy
Alison Mitchell
Euan Paterson
Kirsty Boyd
Flora Odea
Michelle Gillies
Alistair McKoeown
Helen Morrow
Catriona Rostron
Elizabeth Ireland
Heidi May
Jackie Chaplin
Maggie Grundy
Marysia Williamson
Nick Pace
Patricia Wallace
Peter Kiehlmann
Sally Chisholm
Sheena Kilpatrick
Emma Dymond
Gary Morrison