Background The End of Life (EoL) Care Strategy (2008) recommends that consistent ‘co-ordination of care’ and ‘delivery of high quality services in all locations’ is essential across a healthcare economy. Due to historical development and redesign of community services within a large healthcare economy in the North West of England, there were three different community policies for anticipatory medication at the EoL and five different prescription and authorisation forms. Collaborative working is essential to develop consistent, high standard EoL care while minimising potential risk in all care settings.
Aim To assess the clinical impact of generic documentation for ‘Just in Case 4 Core Drugs’ (JiC4CD) anticipatory prescribing at the EoL across a healthcare economy.
Method A multidisciplinary group of clinical experts from all the key stakeholder organisations reviewed the existing processes and documentation, and an ideal clinical pathway was agreed. A Task and Finish group designed and implemented new documentation in line with this pathway, including:
single prescription and authorisation booklet
JiC4CD pack (issued from community, hospital and hospice pharmacies)
Results The clinical impact of the JiC4CD booklet and pack was demonstrated with regard to:
EoL symptom control
prescribing and administration clinical incidents
crisis domiciliary visits and unplanned hospital admissions
place of death
healthcare professional satisfaction
Facilitating factors and barriers to implementation are discussed.
Conclusion Single generic documentation for JiC4CD anticipatory medications across a healthcare economy not only has a positive impact on individual patients, but the process also demonstrated benefits of cross-organisational partnership collaboration to achieve ‘high quality care for all adults at the EoL’.
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