Background A Pilot Urgent Response Service was launched by the Hospice @ Home team due to it being identified that the nature of care needs for patients in the community were changing. More people required an urgent response for care crisis, symptom management, emotional distress and end of life care.
Aim The service aimed to support the Clinical Nurse Specialist and Primary Care Team in managing patients with urgent palliative care needs by coordinating a visit within two hours of a referral. The service was available to any patient already known to the Community Palliative Care Team (CNS, Hospice @ Home and Day Hospice).
Approach To ensure the service was responsive and effective the Duty CNS, who provides a first response telephone service, and the Urgent Response Nurse would work closely together. The majority of Urgent Response referrals were from the Duty CNS following an identified need. The Hospice @ Home service allocates a Band 5/6 nurse each day to carry out Urgent Response visits. Each visit involves a holistic assessment and management of urgent concerns and problems.
Outcome Following a three month pilot an audit of the 30 patients referred was carried out. 95% of the visits were carried out within two hours of referral. The service:
Supported patients in crisis to remain at home
Assessed and managed symptoms
Identified patients with palliative care emergencies and facilitated admission
Supported patients and families in emotional distress
Carried out urgent assessment/review.
Direct feedback from patients, relatives and colleagues was extremely positive highlighting that the service provided timely, effective and supportive care.
Conclusion Due to the audit results and positive impact of the service the pilot was extended and the service continues. In addition the service facilitated more effective working relationships and team integration between H@H and the CNS team.
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