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6 Bridging the gap – an educational initiative to improve communication and decision making at end of life care at a district general hospital and its local area
  1. N Gunawardena,
  2. J Bichard,
  3. M Johnston,
  4. E Mackenzie,
  5. A Hagena,
  6. R Stewart,
  7. C Lai,
  8. E Shekarchi-Khanghahi,
  9. L Stockton,
  10. S Yusuf and
  11. J Sui
  1. North Middlesex Hospital


Background and introduction North Middlesex University Hospital (NMUH) is a district general hospital that serves the culturally and ethnically diverse London boroughs of Haringey and Enfield. In a May 2018 questionnaire, NMUH staff reported that spiritual, religious and cultural factors frequently play a pivotal aspect of end of life care and that their own knowledge could be better in addressing these factors. An educational initiative called Bridging the Gap was established with two distinct arms (community and medical staff) to improve communication and decision making at end of life care in NMUH and its local area.

Methods and results In the first phase of the community arm, religious, spiritual, cultural and social care leaders from the local community were invited to a pilot session and two workshops. Here, they were introduced the medical, moral and ethical considerations that doctors and other medical staff contend with when providing end of life care. 37 leaders from 13 distinct groups attended these events and there was an improvement in participants’ confidence and familiarity towards DNAR, ACP and end of life care discussions.

In the medical staff arm a workshop was arranged for NMUH staff and community palliative care teams, where the Greek, African & Caribbean and Muslim perspectives towards end of life care were explored and practical steps of how to manage their specific needs were discussed. Confidence rating of participants in managing these perspectives improved from 2.68/5 to 4.47/5.

Conclusions In the community arm, different approaches need to be employed to engage hard to reach leaders whilst simultaneously arranging seminars and forums to disseminate information to the wider public via established contacts from the previous workshops. For the medical staff arm there are more perspectives prevalent (Jewish, Turksih, Eastern European) in the local area that need to be explored via future workshops.

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