37 The use of personalised end of life care pathway at the royal surrey county hospital. Issue Volume 9: Issue (2019)Supplement 1 (March 2019)

• Record Type: Journal Article
• Authors: Thomson, Helen; Webber, Katherine
• Is Part Of: BMJ supportive & palliative care. Volume 9: Issue (2019)Supplement 1
• Page Start: A22
• Page End: A23
• Publication Date: 2019-03
• Subjects: Palliative treatment -- Periodicals; Terminal care -- Periodicals; 616.029
• DOI: 10.1136/bmjspcare-2019-ASP.60
• Languages: English
• ISSNs: 2045-435X

Abstract

Abstract : 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.