Palliative care must change, grow and mature in response to the growing number and complexity of needs of community patients. Such demands particularly challenge conventional delivery of day hospice. In response our hospice redesigned day service provision to modernise bespoke day facilities, appoint a day hospice sister and introduce several novel clinical interventions. Patient outcome measures were introduced and research projects undertaken.
The aim of the study was to evaluate whether extended day hospice services could address more patient needs. Newly developed services were introduced in the period April 2015 – May 2016. Management and clinical key performance indicators were obtained for this period and compared with annual data from the previous year. Two facilitated focus groups were undertaken with the multidisciplinary team and with the management team to better understand the service developments and participant’s aspirations for day services.
It was found that introducing five additional patient services – Blood transfusion clinic; Progressive Supranuclear Palsy support group; Motor Neurone Disease clinic; Multi System Atrophy support group and a Carers’ support group – led to a 27% increase in attendances. Staff, patients and their families were recruited to three research projects by three hospice staff as a core part of their role, and five staff contributed to qualitative studies or data collection. The qualitative data indicated that staff were pioneering the new well-coordinated services but were challenged by the time available to capture data. The management team had a vision for further expansion of sustainable services and innovative approaches of working in partnership with the local acute trust and community care providers.
In conclusion, a diversification of day services offered to patients and carers can be facilitated with engaged managerial and professional staff without a significant increase in core workforce.
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