Following the recommendations of the Neuberger Report on the use of the Liverpool Care Pathway (LCP) and subsequent guidance from Scottish Government (SG), we developed a means of recording, evidencing and auditing end-of-life care which met requirements of the SG’s four principles, as follows:
Informative, timely, sensitive communication
Significant decisions about a person’s care, including diagnosing dying, are made on the basis of multi-disciplinary discussion.
Each individual person’s physical, psychological, social and spiritual needs are recognised and addressed as far as is possible.
Consideration is given to the wellbeing of relatives or carers attending the person.
Thirteen key objectives were agreed in relation to evidencing and auditing appropriate end of life care. These were translated into an End of Life Care Record (EoLCR).
The project comprised two stages:
Stage One (5 week pilot)
Ward A: Patients identified as being in the last days/hours of life, care documented in EoLCR
Ward B: Patients identified as being in the last days/hours of life, care documented in Personal Care Records (PCR).
All data compared against the 13 objectives
Minor amendments were made and the EoLCR rolled out to all wards
Stage Two (Retrospective Audit)
A retrospective audit was undertaken of all deaths within the hospice over three months of implementation and compared against the 13 objectives.
We aimed to develop a robust means of evidencing end of life care which followed SG’s 4 principles. This relates to NHS Scotland’s 2020 vision that care will be provided to the highest standards of quality and safety, with the person being centre of all decisions.
The retrospective audit showed improvements in recording end of life care, please refer to Abstract P-65 Table 1 on page A34.
Using the EoLCR allowed us to evidence the principles of good end-of-life care especially in relation to nutrition, hydration and communication with patients/families.
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