Implementing the Last Days of Life Toolkit Laying

Implementing the Last Days of Life Toolkit

Laying the foundation § Before you commence using the various tools it is essential to your success to have the following elements in place: § agreement that there is a problem worth solving § a nominated organisation and facility sponsor and support processes established § a governance plan e. g. the tools and any issues / outcomes are discussed at monthly team meeting § a data collection plan – who will do it, what will be collected and how will it be collected § prepared wards

Support and resources Topic Resources available Project Management � � � Pre implementation Plan/Checklist Project Plan template Team meeting template conduct discussion with pilot team/s Implementation � Guidance Notes for each of the tools: recognising the dying patient and management planning medication management accelerated discharge to die at home Power. Point presentations for each of the tools Staff Information Brochure � �

Measurement to support improvement Why measure? § Minimum dataset: build collective evidence base § Identify any adverse outcome/effect from tool § Demonstrate if any improvement and impact within your hospital/unit “You can’t fatten a cow by weighing it” (Palestinian proverb) Demonstrating and using measurement to support improvement, 2013: Susanna Shouls UK AMBER care bundle team

Baseline Annual Monthly Data Collection • • • Before starting know what your performance is Many data sources will have this information already available to review Identify what you want to improve Identify what data you will use to demonstrate improvement / change Put governance oversight in place for reporting / accountability Collect patient / family / staff stories Data source What to look for Death review database -review death screening data and note the number of patients cared for with a standardised care plan or medication plan -note the number of adverse outcomes in the 24 -48 hours prior to dying -Look at number of readmissions that were due to not being able to be cared at home to die IMMs / incident review - HIE data Look at number of readmissions that were due to not being able to be cared at home to die Retrospective audit Sample - 5 - 15 Consecutive dead patients medical records note the number of adverse outcomes in the 24 -48 hours prior to dying Number of complaints /compliments about end of life Number of RCAs where end of life was an issue

Remember……. § It is what we are already/should be doing for our patients and their families i. e. best practice § Empowers and promotes confidence in nursing staff and junior doctors to be their patients’ advocates § Means the patient/family/carer is heard and has control § Enhances MDT working § Enhances the quality of documentation § Should give staff no extra work, if anything it should save staff time

Contact Details Clinical Excellence Commission Cec-EOL@health. nsw. gov. au