Article Text
Abstract
Background The National Institute of Clinical Excellence emphasise that, ‘People with incurable illness should be able to make choices about care at the end of their life and this includes a choice about where they die.’ The logistics of arranging a rapid discharge for a dying patient from a tertiary cancer centre serving over 2 million population can seem to be an overwhelming challenge for staff. A multi professional working group based at Clatterbridge Centre for Oncology developed and implemented a Rapid Discharge Pathway following close liaison with services and personnel across the Network.
Aims of Study To evaluate the effectiveness of the Rapid Discharge Pathway for the Dying Patient o To resolve emerging challenges associated with emergency discharges at the end of life to a large geographical area.
Method A retrospective audit was completed over a pilot period reviewing medical case notes and pathway documentation.
Discussion Seven patients requested a rapid discharge at end of life with an age range of 23–71 years. Six were successful and one was cancelled due to a rapid deterioration in condition. The study demonstrated the effectiveness of a procedure to ensure discharge medicines were rapidly available and appropriate equipment was in place. There was good communication with families and other healthcare professionals. Challenges included ambulance availability and out of hours discharges. Innovative ways to resolve difficulties are described and the possibility of escorted discharges is explored.