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THE CLINICAL AND STRATEGIC IMPACT OF GENERIC DOCUMENTATION FOR ANTICIPATORY PRESCRIBING AT THE END OF LIFE
  1. Kathryn Smith1,
  2. Andrew Dickman1,
  3. Lisa Drinkwater2,
  4. Purdie Janet1 and
  5. Lynn Atcheson1
  1. 1 Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
  2. 2 Fylde and Wyre CCG

    Abstract

    Background The End of Life (EoL) Care Strategy (2008) recommends that consistent ‘co-ordination of care’ and ‘delivery of high quality services in all locations’ is essential across a healthcare economy. Due to historical development and redesign of community services within a large healthcare economy in the North West of England, there were three different community policies for anticipatory medication at the EoL and five different prescription and authorisation forms. Collaborative working is essential to develop consistent, high standard EoL care while minimising potential risk in all care settings.

    Aim To assess the clinical impact of generic documentation for ‘Just in Case 4 Core Drugs’ (JiC4CD) anticipatory prescribing at the EoL across a healthcare economy.

    Method A multidisciplinary group of clinical experts from all the key stakeholder organisations reviewed the existing processes and documentation, and an ideal clinical pathway was agreed. A Task and Finish group designed and implemented new documentation in line with this pathway, including:

    • prescribing guidance

    • single prescription and authorisation booklet

    • JiC4CD pack (issued from community, hospital and hospice pharmacies)

    • audit form

    Method

    Results The clinical impact of the JiC4CD booklet and pack was demonstrated with regard to:

    • EoL symptom control

    • prescribing and administration clinical incidents

    • crisis domiciliary visits and unplanned hospital admissions

    • place of death

    • carer satisfaction

    • healthcare professional satisfaction

    • Facilitating factors and barriers to implementation are discussed.

    Results

    Conclusion Single generic documentation for JiC4CD anticipatory medications across a healthcare economy not only has a positive impact on individual patients, but the process also demonstrated benefits of cross-organisational partnership collaboration to achieve ‘high quality care for all adults at the EoL’.

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