Background Carers provide vital support to patients yet manage a variety of emotional and physical demands themselves (Ates, Ebenau, Busa, et al., 2018). Use of ‘carer needs’ tools have been shown to reduce carer strain (Aoun, Grande, Howting, et al., 2015). Tools need to be part of wider organisational behavioural and cultural shift to improve person-centred support for carers (Diffin, Ewing, Harvey, et al., 2018). A quality improvement approach encompasses the wider factors involved in changing behaviours and culture in an organisation (NHS England. NHS Change Model).

Aims To evaluate the effectiveness of a quality improvement programme targeting carer support at the hospice.

Methods Baseline audit of 18 records carried out (2019) against the following standards; carers identified, relationship of carer documented, main carer identified, carer limitations documented, identification of needs, separate carer record and carer needs addressed.

Measures implemented share the vision, carer champions identified, record templates modified, staff awareness and process training, promotion of carer resources, embed change. Re-audit of 15 records (2021) to identify impact of improvements.

Results In only 72% of cases a carer was identified in 2019 compared to 100% at review. Compliance with five of the standards in 2019 was between 17% and 22% of the records audited. Average compliance across seven standards in 2019 was 39% and in 2021 compliance was 71%. The re-audit identified a marked improvement in six of the standards audited. In over 90% of cases, the relationship of carer to patient was recorded successfully in both audits.

Conclusion Compliance with the standards increased by 32% on average. The measures implemented were effective at increasing the evidence and awareness of carer support in the organisation. Further improvements are needed in: where information is recorded, assessment of carer limitations and recording of intervention outcomes. Further quality improvements planned include sharing the outcome of the re-audit to provide ongoing momentum, increase number of carer champions and carer support to be incorporated at strategic level.