Background Dying at home is the most common preference yet hospital deaths remain high and costly. Advance care planning (ACP) in hospitals could potentially bridge this gap between patient wishes for future care and meeting them if end of life care discussions take place and information is recorded, reviewed and implemented by the range of professionals involved. This project was developed in response to this identified unmet need for additional support for EKHUFT staff and was funded by the St James Place Foundation.
Methods The main aim of this project was to facilitate ACP discussions and documentation. The project involved the appointment of an EoLC Facilitator at Pilgrims Hospices to facilitate training and support staff to embed ACP in practice and improve collaboration and information sharing. An innovative ‘solution focused’ methodology was employed.
Results/findings Before and after questionnaire found an increase in confidence and competencies in EoLC discussions, recording information and steps that could be taken to facilitate change. Feedback from follow up with staff indicated that change had started to be achieved for some, but not for others, identifying time as a common factor.
Conclusions/interpretations The presence of an EoLC Facilitator providing training and support to hospital staff had shown to be of benefit in facilitating EoLC care discussions and planning. Further work is required to embed this learning into practice. EoLC Facilitator posts within each Trust site is recommended to provide continuing support in ACP including support in the use of electronic systems to record and share information. The solution focused methodology promoted staff confidence, engagement and empowerment.
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