Background Since 2016 NHS Fife acute palliative care team has been developing models of interprofessional working within the acute hospital. The NHS Fife Specialist Palliative Care Service is a single NHS service which includes 2 hospice units, a community and acute team. Although the Specialist Palliative Care service provides medical and nursing input into the acute hospital, the hospital provides occupational therapy, dietetic, chaplaincy and pharmacy support. To ensure we were providing effective and efficient service we have undertaken multiple assurance measures about the service
Footprint of mortality across our hospital-this was to inform which areas we needed to focus opportunities to develop to benefit most patients;
Setting up a structured acute palliative care MDT with all groups that obligates commitment to the service defines the activities of the professionals that attend the group. The MDT also includes learning from complaints, comments and compliments;
Using Palliative Performance Score (PPS) and Phase of Illness (POI) to describe our patient group to provide re-assurance that we are seeing patients of appropriate complexity;
Developing governance reporting mechanisms from our MDT activity.
Results By understanding where the highest mortality is within our hospital we have been able to increase the focus of resource and education into that area. The MDT has resulted in increase in the confidence of the professionals to overcome organisational boundaries results in co-ordination and efficiency of our approach to patients. PPS and POI has shown that we see mostly unstable patients across the range of PPS and POI. We have annual audit activity that reports to the acute operating divisions governance structure.
Conclusions Sharing a structured MDT and using a system for discussing patients has resulted in sufficient improvements in co-ordination of our acute palliative care team. The change in interprofessional monitoring and reporting has raised the profile and impact of acute palliative care.
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