Introduction National guidance has recommended locally developed personalised care plans to ensure needs are met as patients are approaching end of life. The Royal Surrey County Hospital (RSCH) has developed a Personalised End of Life Care Plan (PELICan). This aim of this project is to assess the use of PELICans in a District General Hospital and Cancer Centre over a three year period.
Methods A database was created of all patients with a PELICan at the RSCH over a three year time period (1/9/2014–31/8/2017). Outcome measures included start date of PELICan, presence of PELICan over a weekend and length of time on PELICan before death or discontinuation.
Results 1378 patients had a PELICan over three years. There was an increasing number of patients placed with a PELICan every year (53%, 55% and 62% in successive years). The mean time a patient was cared for with a PELICan before death or discontinuation was 4.5 days (range 1–169 days). Only 7% of PELICans were discontinued over three years, with 71.4% being stopped in the first seven days. 16.8% percent of PELiCans were commenced over the weekend, with this number increasing every year (14.5%, 16.0% and 19.6% in successive years). Of those patients who died with a PELICan, 27.2% died on a weekend.
Conclusion The use of the PELICan is increasing at the RSCH. There has been the introduction of a seven day Palliative care service at the RSCH, which is imperative when considering the proportion of patients dying with a PELICan, as well as those dying on a weekend. Physicians are quite accurate with their prediction of death within the next seven days. The PELICan booklet at the RSCH requires a daily multidisciplinary review, and consequently, most of the PELICans that are discontinued are done so early on.
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