Introduction 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) and we are able to record the GSF status on our hospital electronic patient record (EPR). From this we produce a monthly report with regards to several metrics including% of patients identified as GSF. Therefore, the number of patients with a DNACPR but no GSF status identified were reviewed as a high proportion of these would likely be suitable for GSF.
Methods An end of life care document is completed for patients identified as GSF on the EPR used at DGFT and the DNACPR is also recorded on the EPR. Therefore, on the 8th June 2022 we reviewed all adult wards to see the number of patients with a DNACPR but no GSF document.
Results The results demonstrated that on the 8th June 120 adult inpatients had a DNACPR but no GSF document. This was broken down by wards and shared with the wards to support discussions/education by the specialist palliative care team with regards to GSF implementation.
Conclusion The GSF implementation across DGFT aims to improve the identification of people in the last year of life and the development of an individual plan of care. Working together with the deteriorating patient group we have now developed a prompt that when a DNACPR discussion has been had and a document completed on the EPR for the doctor to consider if GSF is appropriate. We plan to complete this review of DNACPR in 6 months.
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