Background Twice daily admissions meetings at 9am and 3pm are held between the inpatient, community nursing and medical teams at our hospice. To date, the decision to admit is based on bed availability alongside staffing numbers. However, the complexity of the current inpatients is not always objectively considered, and on occasion challenges relationships between the teams. A literature search was carried out to explore current use of acuity/dependency scores and identified an Australasian hospice nursing acuity tool. This was subsequently adapted for our unit.

Aims To create a tool which gives an objective view of the complexity of the patients in a hospice inpatient unit. To use this tool in admissions meetings to aid communication and decision making around capacity to admit. To evaluate the use of this tool after a pilot. To review our inpatient admission guidelines accordingly.

Method Each morning before 9am and each afternoon before 3pm, the complexity score will be calculated by the nurse in charge of the inpatient unit using the acuity tool. This score will then be shared in the admissions meeting, alongside bed and staffing status. It is anticipated that this score will be most useful in the decision of whether or not to admit emergency same day inpatient requests, which understandably cause heightened concern amongst staff. The complexity score will be an objective measure of whether the admission can be achieved safely.

After three months of using this in the admissions meeting, a survey will be sent to staff members involved in the admissions process to understand whether this has been helpful in understanding the ward complexities and aiding decision making in admissions meetings.

Results Interim informal feedback from staff is positive.