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Abstract
The Hospital2home (H2H) Service was initiated to improve handover communication between the Royal Marsden NHS Foundation Trust and the primary care team. Patients who are no longer receiving active anti-cancer treatment are offered a face to face meeting in their home, with key members of the community team invited. Sometimes, due to a change in the patient's condition or patient preference, a telephone handover is conducted instead. The aim of this service is to create a care plan including current and anticipated problems and identify a community key worker. This includes discussions around preferred place of care (PPC) and preferred place of death (PPD). Aim: The aim of this audit was to compare outcomes in the 2 groups. Specifically, actual place of death and achievement of PPD
Method Data were collated between February 2011–August 2011 by H2H staff as part of routine clinical practice Results: A total of 105 case conferences took place between February 2011-August 2011, 67 face to face (FtF) and 39 telephone case conferences (Tcc). In the FtF group 38 patients (57%) have died and in the Tcc group 24 patients (62%) have died. The median survival was 12 days (interquartile range 8-35) in the FtF group and 16 days (IQR 12–33 days) in the Tcc group. Average Palliative Performance Status in each group was 50. Place of death (%): FtF Telephone National Home 53 63 18 Hospice 29 29 4 Nursing Home 8 0 17 Hospital 11 4 58 Not known 0 4 PPD was achieved for 93% of the ftf group and 86% of the Tcc group.
Conclusion High home death rates are achieved in both groups. More patients in the FtF group achieved their PPD. Both services may be viable options. By 2012, we will have collated more data to confirm the preliminary findings.