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P-110 Embedding a quality and safety approach to a statewide end of life (EOL) program
  1. Bernadette King and
  2. Amanda Walker
  1. Clinical Excellence Commission, NSW, Australia


Background The Clinical Excellence Commission’s (CEC’s) EOL program was established in 2013 in order to support provision of safe, quality end of life care in NSW public health organisations (PHOs).

Aim To ensure all patients who die in NSW hospitals benefit from a safe, consistent approach to individualised end of life care.

Methods Four priority areas have been identified: 1. A standardised death screening tool where EOL care is measured for all patients who die in NSW hospitals 2. The introduction of the AMBER care bundle, a systematic approach which allows patients to receive active treatment alongside an end of life care planning approach. 3. Development of a ‘last days of life toolkit’ to ensure all patients receive symptom control, have social, spiritual and cultural needs addressed, and bereavement support for families and carers. 4. SHAPE Conversations: (Supporting Health Professionals in Advance Planning and End of Life Conversations) a joint project with NSW Health lead agencies to educate and mentor clinicians in difficult conversations at the EOL.

Results The death screening tool has been implemented statewide. The AMBER care bundle is available to appropriate units where end of life issues could be improved. A Care of the Dying Observation Chart is being piloted. The chart ensures that dying patients are monitored for symptoms and family distress triggering appropriate intervention.

Discussion/conclusion The CEC End of Life program will play an important role in the introduction of a coordinated whole of system approach to EOL care.

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