Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?

Alison Ward*, Anne Graham, Judith Sixsmith

*Corresponding author for this work

Research output: Contribution to conference typesPosterResearchpeer-review

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Abstract

Background. Most people wish to die at home but in England almost 50% die in hospital, suggesting that more can be done to keep people at home. Some studies have shown this may be possible, especially with adequate support and good pain control. Methods. Rennie Grove Hospice Care (RGHC) carried out an independent study to identify the value of their night team in providing 24/7 care over a period of 145 nights. The study considered whether the provision of overnight care affected decisions to make hospital admissions. Data from a night nurse template recording all overnight visits, a review of 42 patient/carer records of those who had called the night team, a carer questionnaire (n=87), carer interviews (n=18) and staff interviews (n=9), were analysed . Results. The night nurse template recorded 5 overnight admissions made during the study period, all for acute reasons and considered unavoidable. Review of 42 patient records showed 23 hospital/hospice admissions occurred, most during the daytime (18 to hospital, 5 to a hospice) of which only 3 were considered avoidable. The carer questionnaires showed 13 (16%) of their cared for persons had been admitted to hospital in the last few weeks of life, with most reporting the admission was necessary. Staff interviews identified a pride in supporting patients to stay at home, while information from carers gave a clear indication that RGHC nurses enabled their cared for individual to remain at home; that contact with the night team helped prevent or postpone an admission; and without RGHC their alternative would have been 111/999, district nurse or out-of-hours GP. Conclusions. There are occasions when hospital admission is appropriate. However, there was clear evidence showing support from the night team could prevent or postpone hospital admissions.
Original languageEnglish
Publication statusPublished - 15 Mar 2018
EventAssociation for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference - Bournemouth, United Kingdom
Duration: 15 Mar 201816 Mar 2018

Conference

ConferenceAssociation for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference
CountryUnited Kingdom
CityBournemouth
Period15/03/1816/03/18

Fingerprint

Hospices
Caregivers
Hospice Care
Interviews
Nurses
England
Pain
Rennie

Keywords

  • Hospice at home
  • Palliative care
  • end of life
  • hospital admission

Cite this

Ward, A., Graham, A., & Sixsmith, J. (2018). Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?. Poster session presented at Association for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference, Bournemouth, United Kingdom.
Ward, Alison ; Graham, Anne ; Sixsmith, Judith. / Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?. Poster session presented at Association for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference, Bournemouth, United Kingdom.
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abstract = "Background. Most people wish to die at home but in England almost 50{\%} die in hospital, suggesting that more can be done to keep people at home. Some studies have shown this may be possible, especially with adequate support and good pain control. Methods. Rennie Grove Hospice Care (RGHC) carried out an independent study to identify the value of their night team in providing 24/7 care over a period of 145 nights. The study considered whether the provision of overnight care affected decisions to make hospital admissions. Data from a night nurse template recording all overnight visits, a review of 42 patient/carer records of those who had called the night team, a carer questionnaire (n=87), carer interviews (n=18) and staff interviews (n=9), were analysed . Results. The night nurse template recorded 5 overnight admissions made during the study period, all for acute reasons and considered unavoidable. Review of 42 patient records showed 23 hospital/hospice admissions occurred, most during the daytime (18 to hospital, 5 to a hospice) of which only 3 were considered avoidable. The carer questionnaires showed 13 (16{\%}) of their cared for persons had been admitted to hospital in the last few weeks of life, with most reporting the admission was necessary. Staff interviews identified a pride in supporting patients to stay at home, while information from carers gave a clear indication that RGHC nurses enabled their cared for individual to remain at home; that contact with the night team helped prevent or postpone an admission; and without RGHC their alternative would have been 111/999, district nurse or out-of-hours GP. Conclusions. There are occasions when hospital admission is appropriate. However, there was clear evidence showing support from the night team could prevent or postpone hospital admissions.",
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Ward, A, Graham, A & Sixsmith, J 2018, 'Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?' Association for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference, Bournemouth, United Kingdom, 15/03/18 - 16/03/18, .

Does a 24/7 hospice at home service prevent or postpone acute hospital admissions? / Ward, Alison; Graham, Anne; Sixsmith, Judith.

2018. Poster session presented at Association for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference, Bournemouth, United Kingdom.

Research output: Contribution to conference typesPosterResearchpeer-review

TY - CONF

T1 - Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?

AU - Ward, Alison

AU - Graham, Anne

AU - Sixsmith, Judith

PY - 2018/3/15

Y1 - 2018/3/15

N2 - Background. Most people wish to die at home but in England almost 50% die in hospital, suggesting that more can be done to keep people at home. Some studies have shown this may be possible, especially with adequate support and good pain control. Methods. Rennie Grove Hospice Care (RGHC) carried out an independent study to identify the value of their night team in providing 24/7 care over a period of 145 nights. The study considered whether the provision of overnight care affected decisions to make hospital admissions. Data from a night nurse template recording all overnight visits, a review of 42 patient/carer records of those who had called the night team, a carer questionnaire (n=87), carer interviews (n=18) and staff interviews (n=9), were analysed . Results. The night nurse template recorded 5 overnight admissions made during the study period, all for acute reasons and considered unavoidable. Review of 42 patient records showed 23 hospital/hospice admissions occurred, most during the daytime (18 to hospital, 5 to a hospice) of which only 3 were considered avoidable. The carer questionnaires showed 13 (16%) of their cared for persons had been admitted to hospital in the last few weeks of life, with most reporting the admission was necessary. Staff interviews identified a pride in supporting patients to stay at home, while information from carers gave a clear indication that RGHC nurses enabled their cared for individual to remain at home; that contact with the night team helped prevent or postpone an admission; and without RGHC their alternative would have been 111/999, district nurse or out-of-hours GP. Conclusions. There are occasions when hospital admission is appropriate. However, there was clear evidence showing support from the night team could prevent or postpone hospital admissions.

AB - Background. Most people wish to die at home but in England almost 50% die in hospital, suggesting that more can be done to keep people at home. Some studies have shown this may be possible, especially with adequate support and good pain control. Methods. Rennie Grove Hospice Care (RGHC) carried out an independent study to identify the value of their night team in providing 24/7 care over a period of 145 nights. The study considered whether the provision of overnight care affected decisions to make hospital admissions. Data from a night nurse template recording all overnight visits, a review of 42 patient/carer records of those who had called the night team, a carer questionnaire (n=87), carer interviews (n=18) and staff interviews (n=9), were analysed . Results. The night nurse template recorded 5 overnight admissions made during the study period, all for acute reasons and considered unavoidable. Review of 42 patient records showed 23 hospital/hospice admissions occurred, most during the daytime (18 to hospital, 5 to a hospice) of which only 3 were considered avoidable. The carer questionnaires showed 13 (16%) of their cared for persons had been admitted to hospital in the last few weeks of life, with most reporting the admission was necessary. Staff interviews identified a pride in supporting patients to stay at home, while information from carers gave a clear indication that RGHC nurses enabled their cared for individual to remain at home; that contact with the night team helped prevent or postpone an admission; and without RGHC their alternative would have been 111/999, district nurse or out-of-hours GP. Conclusions. There are occasions when hospital admission is appropriate. However, there was clear evidence showing support from the night team could prevent or postpone hospital admissions.

KW - Hospice at home

KW - Palliative care

KW - end of life

KW - hospital admission

UR - https://spcare.bmj.com/content/8/Suppl_1/A25.3

M3 - Poster

ER -

Ward A, Graham A, Sixsmith J. Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?. 2018. Poster session presented at Association for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference, Bournemouth, United Kingdom.