Action 5.15 states

The health service organisation has processes to identify patients who are at the end of life that are consistent with the National Consensus Statement: Essential elements for safe and high-quality end-of-life care

Intent

Patients with end-of-life care needs are identified as soon as possible to maximise opportunities for appropriate decision making and care.

Reflective questions

How does the health service organisation identify patients who are at the end of their life?

How does the health service organisation ensure that these processes are consistent with the National Consensus Statement: Essential elements for safe and high-quality end-of-life care?

Key task

Use the National Consensus Statement: Essential elements for safe and high-quality end-of-life care to develop a systematic process for identifying patients with end-of-life care needs.

Strategies for improvement

Hospitals

The National Consensus Statement: Essential elements for safe and high-quality end-of-life care sets out suggested practice for health service organisations delivering end-of-life care in settings that provide acute health care. It describes 10 essential elements of care.

The fourth essential element in the consensus statement provides detail about the need to use triggers to recognise when patients are approaching the end of life. Considering the likelihood of a patient dying offers opportunities to identify their needs and preferences, review their goals and comprehensive care plan, and consider how best to align care with the individual’s expressed values and wishes. Routine use of simple trigger tools and questions can prompt clinicians to use their clinical judgement to make a holistic assessment of whether a patient has end-of-life care needs.

Develop processes aimed at identifying patients at two critical points:

  • When death is likely in the medium term (that is, within the next 12 months), but episodes of acute clinical deterioration may be reversible
  • When death is likely in the short term (that is, within days to weeks, or during the current admission), and clinical deterioration is likely to be irreversible.

Work with clinicians to set up processes for identifying patients with end-of-life care needs in the health service organisation. A combination of clinical judgement and research-based algorithms is better at identifying end of life than either strategy alone. The consensus statement includes actions to support the development of processes.

A series of online education modules based on the consensus statement and targeted at clinicians working in hospitals is available from the End-of-Life Essentials website.

Day Procedure Services

The National Consensus Statement: Essential elements for safe and high-quality end-of-life care sets out suggested practice for health service organisations delivering end-of-life care in settings that provide acute health care. It describes 10 essential elements of care.

The fourth essential element in the consensus statement provides detail about the need to use triggers to recognise when patients are approaching the end of life. Considering the likelihood of a patient dying offers opportunities to identify their needs and preferences, review their goals and comprehensive care plan, and consider how best to align care with the individual’s expressed values and wishes. Routine use of simple trigger tools and questions can prompt clinicians to use their clinical judgement to make a holistic assessment of whether a patient has end-of-life care needs.

Develop processes aimed at identifying patients at two critical points:

  • When death is likely in the medium term (that is, within the next 12 months), but episodes of acute clinical deterioration may be reversible
  • When death is likely in the short term (that is, within days to weeks, or during the current admission), and clinical deterioration is likely to be irreversible.

It is unlikely that day procedure services will be providing care to patients in the last days of life because of the nature of the service and pre-admission screening. However, some procedures may be appropriate for patients in the last year of life. Therefore, day procedure services need to work with clinicians to set up processes for identifying inclusion/exclusion criteria to determine the appropriateness of admitting patients at end-of-life. Referral and transfer of care guidelines should be developed. Tools exist to assist clinicians in recognising people at end of life, and day procedure services wishing to implement a tool should assess its applicability to their service context.

A series of online education modules based on the consensus statement and targeted at clinicians is available from the End-of-Life Essentials website.

MPS & Small Hospitals

The National Consensus Statement: Essential elements for safe and high-quality end-of-life care sets out suggested practice for health service organisations delivering end-of-life care in settings that provide acute health care. It describes 10 essential elements of care.

The fourth essential element in the consensus statement provides detail about the need to use triggers to recognise when patients are approaching the end of life. Considering the likelihood of a patient dying offers opportunities to identify their needs and preferences, review their goals and comprehensive care plan, and consider how best to align care with the individual’s expressed values and wishes. Routine use of simple trigger tools and questions can prompt clinicians to use their clinical judgement to make a holistic assessment of whether a patient has end-of-life care needs.

Develop processes aimed at identifying patients at two critical points:

  • When death is likely in the medium term (that is, within the next 12 months), but episodes of acute clinical deterioration may be reversible
  • When death is likely in the short term (that is, within days to weeks, or during the current admission), and clinical deterioration is likely to be irreversible.

Work with clinicians to set up processes for identifying patients with end-of-life care needs in the health service organisation. A combination of clinical judgement and research-based algorithms is better at identifying end of life than either strategy alone. The consensus statement includes actions to support the development of processes.

A series of online education modules based on the consensus statement and targeted at clinicians working in hospitals is available from the End-of-Life Essentials website.

Hospitals

The National Consensus Statement: Essential elements for safe and high-quality end-of-life care sets out suggested practice for health service organisations delivering end-of-life care in settings that provide acute health care. It describes 10 essential elements of care.

The fourth essential element in the consensus statement provides detail about the need to use triggers to recognise when patients are approaching the end of life. Considering the likelihood of a patient dying offers opportunities to identify their needs and preferences, review their goals and comprehensive care plan, and consider how best to align care with the individual’s expressed values and wishes. Routine use of simple trigger tools and questions can prompt clinicians to use their clinical judgement to make a holistic assessment of whether a patient has end-of-life care needs.

Develop processes aimed at identifying patients at two critical points:

  • When death is likely in the medium term (that is, within the next 12 months), but episodes of acute clinical deterioration may be reversible
  • When death is likely in the short term (that is, within days to weeks, or during the current admission), and clinical deterioration is likely to be irreversible.

Work with clinicians to set up processes for identifying patients with end-of-life care needs in the health service organisation. A combination of clinical judgement and research-based algorithms is better at identifying end of life than either strategy alone. The consensus statement includes actions to support the development of processes.

A series of online education modules based on the consensus statement and targeted at clinicians working in hospitals is available from the End-of-Life Essentials website.

Day Procedure Services

The National Consensus Statement: Essential elements for safe and high-quality end-of-life care sets out suggested practice for health service organisations delivering end-of-life care in settings that provide acute health care. It describes 10 essential elements of care.

The fourth essential element in the consensus statement provides detail about the need to use triggers to recognise when patients are approaching the end of life. Considering the likelihood of a patient dying offers opportunities to identify their needs and preferences, review their goals and comprehensive care plan, and consider how best to align care with the individual’s expressed values and wishes. Routine use of simple trigger tools and questions can prompt clinicians to use their clinical judgement to make a holistic assessment of whether a patient has end-of-life care needs.

Develop processes aimed at identifying patients at two critical points:

  • When death is likely in the medium term (that is, within the next 12 months), but episodes of acute clinical deterioration may be reversible
  • When death is likely in the short term (that is, within days to weeks, or during the current admission), and clinical deterioration is likely to be irreversible.

It is unlikely that day procedure services will be providing care to patients in the last days of life because of the nature of the service and pre-admission screening. However, some procedures may be appropriate for patients in the last year of life. Therefore, day procedure services need to work with clinicians to set up processes for identifying inclusion/exclusion criteria to determine the appropriateness of admitting patients at end-of-life. Referral and transfer of care guidelines should be developed. Tools exist to assist clinicians in recognising people at end of life, and day procedure services wishing to implement a tool should assess its applicability to their service context.

A series of online education modules based on the consensus statement and targeted at clinicians is available from the End-of-Life Essentials website.

MPS & Small Hospitals

The National Consensus Statement: Essential elements for safe and high-quality end-of-life care sets out suggested practice for health service organisations delivering end-of-life care in settings that provide acute health care. It describes 10 essential elements of care.

The fourth essential element in the consensus statement provides detail about the need to use triggers to recognise when patients are approaching the end of life. Considering the likelihood of a patient dying offers opportunities to identify their needs and preferences, review their goals and comprehensive care plan, and consider how best to align care with the individual’s expressed values and wishes. Routine use of simple trigger tools and questions can prompt clinicians to use their clinical judgement to make a holistic assessment of whether a patient has end-of-life care needs.

Develop processes aimed at identifying patients at two critical points:

  • When death is likely in the medium term (that is, within the next 12 months), but episodes of acute clinical deterioration may be reversible
  • When death is likely in the short term (that is, within days to weeks, or during the current admission), and clinical deterioration is likely to be irreversible.

Work with clinicians to set up processes for identifying patients with end-of-life care needs in the health service organisation. A combination of clinical judgement and research-based algorithms is better at identifying end of life than either strategy alone. The consensus statement includes actions to support the development of processes.

A series of online education modules based on the consensus statement and targeted at clinicians working in hospitals is available from the End-of-Life Essentials website.