Introduction Referrals for admissions are received from health care professionals in the community and acute trust with GP’s knowledge. Requests are assessed by the admission co-ordinator and a member of the Hospice Medical team on an individual basis, without discrimination and in accordance with the admission policy.
A tool has been adapted from Luton Community Service Palliative care response criteria. It is based on RED/AMBER/GREEN (RAG) category model.
Aim The aim is to ensure a responsive service based on patient needs. It provides clinicians with a user-friendly tool to support decision making when prioritising request for admission to the Hospice.
Method An audit on the use of the tool was undertaken.
RAG tool covers 3 categories; End of life care, symptom management and Psychological/social support.
RED – Death expected within hours/days, Symptom control and Carer breakdown. Admission/bed offered within 24 hours
AMBER – Death expected within days/weeks, symptoms assessed but remain unresolved, Psychological support requiring regular observation. Patient is admitted within 3 days.
GREEN – Death expected within weeks/months. Respite for family. Admission offered if no red or amber patients are waiting.
The tool is used in conjunction with a list of questions when dealing with request for admission.
Using the criteria, admission was prioritised according to RAG tool and response time documented.
Results During a 12months period, 202 patients were admitted to the IPU from home or from hospital. 140 of these admissions were considered to be RED requests, 47 were AMBER and 15 were GREEN.
Admission between 2–24hrs = 140
Admission between 24hrs – 36hrs = 47
Admission between 36hrs and over = 15
Summary The RAG tool was found to be successful in prioritising request for admission. Streamlining the process of admission meant that patients requiring urgent admission were prioritised therefore preventing possible hospital admission and achieving their Preferred Place of Care and Death.
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