Background A third of hospital patients are in their last year of life and almost 50% of people die in hospital. At Dudley Group NHS Foundation Trust (DGFT) we have implemented the Gold Standards Framework (GSF). To support co-ordination of care across settings a template was developed using the ‘GREAT’ acronym (G – GSF register, R – resuscitation status, E – end of life care medications, A – advance care planning and T – treatment escalation plan) to support discharge summaries for GSF identified patients.
Method On the electronic summary of admission completed for each patient on discharge there is a section to complete if the patient has been identified as GSF which includes the GREAT template. A random sample of GSF identified patients was identified and summary of admission reviewed to see if the GREAT template sections had been completed.
Results From audits approximately 60% had GSF recorded on the summary of admission and less than a third had any of the other sections completed. Therefore, working with data analyst a Power BI was developed that provides a break down by ward and for each patient identified as GSF the GREAT template sections completed within the summary of admission. This is then used by the ward to drive improvements in the quality of information communicated to community teams and primary care.
Conclusion Co-ordination of care across settings is important to ensure continuity of care and therefore, it is important to ensure discussions regarding end of life care are communicated to community teams. The GREAT acronym and Power BI are useful tools to drive improvements in the quality of information and communication for patients identified as GSF and supports the development of an individual plan of care.
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