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10 steps to facilitating patient death at home
  1. Doa’a Kerwat1,2,
  2. Meelad Sayma2,3,
  3. Dina Saleh3,
  4. Folashade Oyewole3,
  5. Samad Wahid3,
  6. Shiraz Jamshaid3 and
  7. Aaniya Ahmed3
  1. 1Barts and the London School of Medicine and Dentistry, London, UK
  2. 2Peninsula College of Medicine and Dentistry, London, UK
  3. 3Imperial College London, London, UK

Abstract

Introduction Evidence suggests that most patients want to die at home, however most die in hospital.

Aim To identify specific action points to facilitate more patients to achieve home death, should they wish to do so.

Methods A two-step study design was adopted. A systematic literature review (SLR) and primary qualitative data collection. In the SLR 3241 papers were retrieved. 72 articles remained after screening and filtering processes. Qualitative articles were analysed using meta-ethnography and quantitative articles were analysed using a descriptive approach. 33 in-depth interviews were conducted with experts in end-of-life care delivery, with approval from Imperial College Research Ethics Committee. Thematic Analysis of interview transcripts was conducted. The results from both the SLR and primary data collection were then amalgamated to produce a set of overarching barriers and facilitators. Subsequently, action points were produced to overcome the barriers and facilitators identified.

Results Ten action points were identified to enable patients to achieve home death. These action points include: ‘coordinate services’ and ‘evaluate the efficiency of current resource allocation to enhance quality’.

Conclusions By implementing these ten action points, the barriers to achieving home death would be dissolved, allowing patients to die in their preferred location. However, it is important to acknowledge that these action points are both time-consuming and potentially financially straining to achieve. Consequently, further research is required to identify how susceptible these action points are to implementation, prioritising those with the greatest impact.

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