WMQRS Good Practice Event Implementing Amber Care Bundle to improve End of life care.

Liverpool Care Pathway – Best practice Tool used on all adult wards for patients in the last days of life where there is deemed no reversible cause for their deterioration. The use of the AMBER Care Bundle complies with the NICE Quality Standard QS013 - End of life care for adults & Peer Review Self-Assessment for clinical teams i.e. COPD/Cardiology

What does it do? Gap between health and dying with uncertain outcome Ability to recover or deteriorate Communication issues DNACPR Ceiling of Care Communication Situation Plan Choices – PPC/PPD Advance Decisions

Benefits include – improved decision making positive impact on multi-professional team communication & working increase in nurses’ confidence about approaching medical colleagues to discuss treatment plans patients are treated with greater dignity & respect greater clarity around patient preferences & how they can be achieved reduction in unnecessary interventions & readmissions

Why implement AMBER on a Respiratory Ward ? Reduce the number of patient deaths on the ward To improve the gap in the quality of care for those on the LCP Support active treatment alongside an end of life care plan and symptom manage. FOR MANY COPD PATIENTS RECOVERY IS UNCERTAIN AND READMISSION RATES ARE HIGH, WE SHOULD BE ASKING: Is the patient deteriorating, clinically unstable and with limited reversibility? Is the patient at risk of dying in the next 1-2 months?

Facts : People with respiratory conditions are the most likely to die in hospital and the least likely to die at home.  14 % of all deaths in England are attributed to respiratory disease rising to 20% if lung cancer is included. 69% of people with respiratory conditions (other than lung cancer) die in hospital – higher than any other condition 10% of deaths involving pneumonia or acute respiratory infection die at home

Acute/community interface Rapid Discharge Pathway Produced an Electronic Discharge Summary page Out of Hours Form Community Prescribing – PRN drugs EOL Talk at Local/National Conferences etc.

Contact Details for further information End of life Care Facilitators at Worcestershire Acute Hospital Trust Teresa.Barley@worcsacute.nhs.uk & Jennifer.Garside@worcsacute.nhs.uk