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P84 Quality monitoring in a hospice
  1. Pauline Flanagan and
  2. Michelle Roberts
  1. Douglas Macmillan Hospice, Stoke-on-Trent, UK

Abstract

Background/context Hospices are expected to quantify the quality of care and demonstrate outcome improvements1,2. There has been a change in emphasis from system and process to outcome1-4. However, little hospice-specific guidance is available1-6.

The DMH produces quarterly quality monitoring (QM) reports and is seeing useful intelligence.

Aim

  • To produce hospice-specific intelligence

  • To evidence that the hospice remains low risk.

Approach used QM is part of the hospice’s well-established clinical governance function. Reports use monthly (& rolling annual) data with published statistics (Office of National Statistics; National End of Life Care Intelligence Network).

Electronic patient-notes enable data collation in a way that was impossible with paper notes.

Hospice-specific outcome indicators have been developed to evidence compliance with outcome measures given in the NICE 2011 quality statements2 and the essential standards of quality and safety4.

Outcomes The hospice has robust evidence of the following:

  • Number (%) and diagnosis of patients receiving care

  • Primary care aim

  • Equity of access

  • Impact of the 24/7 advice line

  • Percentage of hospice

    • deaths of patients offered an ACP

    • patients achieving their preferred place of care.

  • Percentage of in-patients

    • on the LCP at the time of their death.

    • assessed for risks associated with moving and handling.

    • experiencing minor/serious injury.

    • assessed for tissue viability within 6 hours of admission.

  • Waterlow score - an indication of patient frailty.

The DMH can demonstrate that twice as many EOL patients receiving care die at home as those not referred to the hospice.

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