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Our Wish for End of Life Care- A collaborative approach to Improving End of Life Care

Authors:

Gillian Rufli ,

Beaumont Hospital, IE
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Ann Quinn,

Beaumont Hospital, IE
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Celine Deane,

Beaumont Hospital, IE
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Kate Costelloe,

Beaumont Hospital, IE
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Kevin Lyons,

Beaumont Hospital, IE
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Marie Hennigan,

Beaumont Hospital, IE
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Cuypers Jenny,

Beaumont Hospital, IE
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Coranne Rice

Beaumont Hospital, IE
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Abstract

Background: Beaumont   Hospital has a high level of activity surrounding end-of-life care. The hospital has introduced many   initiatives to implement the Quality Standards for End of Life Care in Acute  Hospitals. As part of a review, the End of Life Care  Committee decided to engage with staff  to determine what supports them to deliver good quality end of life  care (EoLC), and to identify any additional initiatives required to support   staff in this work.

Aims & Objectives:

To celebrate good practices and improvements in EOLC to date.

To share the experience of bereaved relatives with staff members.

To understand what supports staff to deliver compassionate person  centred end of life care and what are the factors that act as barriers.

To inform the EoLC Committee work plan.

Methodology: A workshop event was determined to be the   most appropriate mechanism to achieve the goals outlined and a number of  communication approaches were taken to ensure staff from as many different  departments and disciplines as possible attended. A total of 52 staff attended the event representing 11 different occupational groups. The event was designed to facilitate   participants to connect with compassion and feeling. It began by showing ‘A   Wish’ a short animated video about the End of Life care in Acute hospitals. This   was followed by actors presenting dramatised accounts of the real EoLC  experiences of six bereaved families. These stories demonstrated the positive  impact of the quality improvement initiatives already in place, and   highlighted the negative impact of some poor practices. The participants were   invited to reflect on their reaction to   the material by writing one word on an A4 page.

Three questions were posed to the participants. 1).What supports you to deliver   compassionate EolC? 2).What factors prevent this from happening? 3). What   else could support the delivery of compassionate EoLC? The conversation at   each table was facilitated by experienced facilitators. Each group recorded their answers on flip   chart paper and the groups were invited to feedback the conversation at their   table to the main group. Analysis of the words, flip chart pages and  facilitator notes revealed the themes outlined below.

Results & Discussion: The   Physical Environment: limited availability of single rooms for   patients and private spaces impacts on EoLC. The cost of car parking is a  problem for families. Resources such as the End of Life Symbol, canvas  property bags and  resource folders are valued by staff.

The Work Environment: Strong role models and appropriate  staffing combined with good team work involving all staff grades is essential  for good EoLC.

Staff   Supports:   Personal experience and access to specialist knowledge, e.g. Palliative Care,   Chaplaincy, Mortuary staff, Social Work and the Bereavement Service supports   good EoLC.

Education   & Training: Staff are empowered by education and training.   There is a need for in-depth education on EoLC issues, in addition to the   programmes already available.

Communication within teams and between staff and patients   and their families is essential. There is a need for communication skills   training.

Patient/ Family Engagement: We need to engage with patients and families   about end of life care and seek feedback in a structured way.

Conclusions:The event raised awareness of the  EoLC programme and provided a rich source of information for the EoLC Committee. The findings endorsed the Hospitals approach to improving the quality of EoLC while also highlighting areas requiring further work.

Implications: The  information gained, together with the Quality Standards for End of Life Care have informed EoLC Committee work plans.
How to Cite: Rufli G, Quinn A, Deane C, Costelloe K, Lyons K, Hennigan M, et al.. Our Wish for End of Life Care- A collaborative approach to Improving End of Life Care. International Journal of Integrated Care. 2017;17(5):A177. DOI: http://doi.org/10.5334/ijic.3485
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Published on 17 Oct 2017.

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