Extended-hours palliative care service with a hospital-avoidance and enhanced-care approach: report of a quality improvement project

Int J Palliat Nurs. 2020 Jun 2;26(5):222-228. doi: 10.12968/ijpn.2020.26.5.222.

Abstract

Background: A community palliative care service (CPCS) identified its after-hours support as sub-optimal in avoiding acute hospitalisation and supporting patients to remain at home. It created and conducted a pilot of an extended hours palliative care service (EHPCS) using current resources.

Aims: To evaluate the efficacy of an extended hours palliative care service pilot.

Methods: Retrospective chart review of after-hours calls taken before the trial, usual care, was undertaken. During the trial, quantitative data was gathered of the outcome of each after-hours call, including outcomes of occasion of service, reason for and length and times of calls.

Findings: The extended hours palliative care service, compared with usual care, showed an almost 50% decrease in acute hospitalisation, nearly doubled after-hours palliative care unit admission and a 17% increase in patients staying in their home. EHPCS was positively received by CPCS staff, despite cost and workforce impact.

Conclusions: EHPCS can positively impact on reducing avoidable hospitalisations and facilitate palliative care patients to be in their preferred place of care.

Keywords: After-hours service; Avoidable hospitalisation; Community; Model of care.

MeSH terms

  • After-Hours Care*
  • Delivery of Health Care
  • Health Services Accessibility*
  • Hospice and Palliative Care Nursing
  • Hospitalization / statistics & numerical data
  • Humans
  • Medical Staff
  • Palliative Care / organization & administration*
  • Pilot Projects
  • Qualitative Research
  • Quality Improvement*
  • Retrospective Studies