Background The discharge of a patient from hospital, who is nearing the end of life requires skilled, careful coordination and communication and can be highly time consuming. The Hospital Palliative Care Discharge Facilitator role is responsible for actively supporting discharge to people’s preferred place of care. Research suggests that responsive, seamless discharges most often occur when one person is dedicated to the function to ensure that all aspects of the discharge process have been covered and nothing has been missed. The post holder was outreached from the hospice to the district general hospital for one year.

Aims Reduction in hospital beds days for patients at the end of life who do not wish to die in hospital. Prevention of hospital admissions by ascertaining patient’s wishes, completing their advance care plan in the Emergency Department. Free NHS staff from organising care packages.

The objectives of the role:

• To identify daily patients who are end of life

• Expedite complex discharges by attending all wards and the Emergency Department

• Offer advice, support and consider available options with discharge plans.

Results

• 108 successful discharges in last nine months to own home or care setting

• 58 people were not discharged often due to a late referral and died during discharge planning or packages of care were unsourced.

Conclusion One of the values of the hospice is that we are innovative and bold – this is played out daily across the hospital. The role is responsive and creative. The success of coordinating complex discharges in a busy acute setting is supported by the hospice philosophy. There is a refreshing and unique quality about practising in an organisation you are not accountable to. The ability to challenge and question is well received and respected.