Hospice service redesign aims to achieve the greatest impact for the greatest number of people within limited resources. The strategic direction within the NHS is towards care as close to home as possible, reducing avoidable admissions and improving patient experience of end of life care. However there is little published evidence describing patient use of hospice inpatient services, despite this significant resource. Our aim was to enhance understanding of why patients are admitted to two hospice inpatient units within one Health Board area, to describe the characteristics of patients admitted and explore their needs and wishes in this process.
We are conducting a prospective mixed methods evaluation. Using case note review, we are collecting data on approximately 250 hospice inpatient admissions. In addition, we are conducting up to 40 interviews with patients and carers to explore expectations and feelings around the admission; and seek feedback from the referrer and the receiving staff about appropriateness of admission and alternatives to admission.
We will present preliminary data on the reasons for referral to the hospice inpatient services, describe characteristics of patients referred including Adapted Karnofsky Performance Score, Phase of Illness and iPOS on admission; along with preliminary qualitative findings regarding patient and carer perspectives about hospice admission.
Our findings will inform our understanding of the use of hospice inpatient services and how resources can be most effectively allocated to meet patient and family needs and preferences within a locality. This will allow meaningful service redesign, ensuring the patient experience informs change.
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