The Palliative Care Team from Blackpool Teaching Hospitals Trust and Trinity Hospice aimed to provide daily in-reach into the Emergency Department at Blackpool Victoria Hospital, with the hope of increasing the number of patients achieving their preferred place.
Between February 2021 and January 2022 a total of 69 patients were supported and 28 per cent of those were discharged back to their place of residence or the local hospice, avoiding admission and reducing length of stay by on average a day, saving 78 bed days.
The initiative which was led by Dr Harriet Preston Clinical Lead for End of Life Care at Blackpool Teaching Hospitals and Emma Dawson, Trainee Advanced Practitioner at Trinity Hospice, drew a number of conclusions from the improvement work. Notably the project saw a larger number of patients than anticipated, highlighting the need for further work to promote anticipatory advance care planning. Ultimately the project showed that early specialist palliative care in-reach into emergency departments can prevent unnecessary admissions for patients in their last year of their life as well as providing support and education to staff.
At least week’s QI Awards at Blackpool Teaching Hospitals, the project was awarded the Special Recognition Award in Honour of Pakho Li, a former colleague at the Trust who sadly passed away but was a huge advocate for quality improvement learning and methodology.
Dr Preston said: “Although it is enough to know that we have tried our best for patients and those important to them, we were absolutely delighted to receive the special recognition award.
“We were privileged to have been able to help care for Pakho during his final illness so to receive the award in his honour was incredibly special. This is also for all the staff in ED who are constantly striving to provide the best care for our patients in very challenging circumstances.”
Sarah Roberts, Head of Community and Hospital Services at Trinity Hospice, said: “We are absolutely delighted that our hospital Palliative Care Team has won the special Quality Improvement Award in memory of Pakho Li, recognising the incredible collaborative work taking place between Trinity and the Trust in the hospital’s Emergency Department.
“By working together through our A&E pilot project, our hospital team is able to assess patients who are nearing the end of their life as they come to the ‘front door’ of the hospital. If their wish is to spend their final days at home or in a care home and they don’t have any complications, they can determine their reason for attending the emergency department and get them safely back to their preferred place without an admission onto a ward.
“Over the pilot period, of the 69 patients referred to our hospital Palliative Care Team who visited the Emergency Department towards the end of their life, they were able to get 19 (28%) to an alternative, more appropriate care environment on the same day. That saved the Trust 78 ‘acute bed days’, and is something we are all incredibly proud of here at Trinity.”