1. “One Chance to get it right’ End of Life Care
Wirral University Teaching
Hospital

2. 90% of inpatients are recognised as dying 48 hours before death and 100% of these have a personalised care plan This is to be achieved by by September 2015

3. The Team Sue Peters: Day to Day Leader
Clare Brown: End of Life Transform Lead Nurse
Claire Ashton: Quality and Safety Analyst
Heather Aitken, Liz Watkins, Denise Farrance
Janice Evans: Specialist Nursing Lead Wirral CT
Nick Mamo, Sophie Duckworth
Geraldine McCaffery: pharmacy
Anne McGinnity: Divisional Manager
Melanie Maxwell: Associate Medical Director
Cathy Lewis-Jones: Palliative Care Consultant
Alan Pugh: Administrator L+D,HROD
Jill Galvani: Director of Nursing/Executive Sponsor

4. Primary Drivers Secondary Drivers Aim / Outcome
Primary Drivers
Secondary Drivers
Knowledge of prognostic indicators of dying
Aide memoir prompt for Care of Dying
90% of inpatients are recognised as dying 48 hours before death and 100% of these have a personalised care plan (by September 2015)
Education and training healthcare workers
Handover of nursing and medical staff
Communication with patient, carers and family; understanding patients’ needs and wishes
Priorities for Care of the Dying person
Bereavement Support
Individualised Care plan
Advance Care Planning
Amber Care Bundle
Clinical Audit
Mortality audit
Critical incidents
Coding/EoL Data measurement

5. Methods
Pilot wards 33/36
Assessment/Prompt Tool/Powerpoint presentation
E-learning module/Podcast
WUTH monthly Pilot meetings
E-communication
Baseline Audit completed in Pilot Ward Areas.
Communication with Ward Managers, Consultants, trainees
Training log/Top up training

7. Oct
2014
Nov 2014
Dec 2014
Jan
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
50.0% (6/12)
14.3% (1/7)
50.0% (9/18)
40.0% (6/15)
41.7% (5/12)
21.4%% (3/14)
31.3% (5/16)
22.2% (2/9)
30% (3/10)
66.7% (10/15)
33.3% (3/9)
44.4% (4/9)

8. Oct
2014
Nov 2014
Dec 2014
Jan
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
58.3%
(7/12)
71.4%
(5/7)
83.3% (15/18)
86.7%
(13/15)
75.0%
(9/12)
50.0%
(7/14)
68.8% (11/16)
100% (9/9)
70.0% (7/10)
80.0% (12/15)
77.8% (7/9)
88.9% (8/9)

9. Oct
2014
Nov 2014
Dec 2014
Jan
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Patient
25.0% (1/4)
40.0% (2/5)
37.5% (3/8)
50.0% (4/8)
16.7% (1/6)
50.0% (2/4)
100% (4/4)
66.7% (2/3)
50.0% (1/2)
Relative/ carer
85.7%
(6/7)
83.3% (5/6)
92.9% (13/14)
100% (12/12)
100% (9/9)
80.0% (8/10)
100% (11/11)
100% (8/8)
100% (7/7)

10. Oct
2014
Nov 2014
Dec 2014
Jan
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Patient
55.6%
(5/9)
40.0% (2/5)
36.4% (4/11)
72.7% (8/11)
55.6% (5/9)
57.1% (4/7)
80.0% (4/5)
100% (5/5)
88.9% (8/9)
83.3% (5/6)
100% (4/4)
Relative/ carer
83.3% (10/12)
93.3% (14/15)
100.0% (13/13)
80.0% (8/10)
100.0% (14/14)
92.3% (12/13)
100% (9/9)
90.0% (9/10)
100% (14/14)

11. Oct
2014
Nov 2014
Dec 2014
Jan
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
25.0% (3/12)
42.9% (3/7)
27.8% (5/18)
33.3% (5/15)
16.7% (2/12)
35.7% (5/14)
25.0% (4/16)
44.4% (4/9)
80.0% (8/10)
53.3% (8/15)
30.8% (4/13)
66.7% (6/9)

12. Oct
2014
Nov 2014
Dec 2014
Jan
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
50.0% (6/12)
42.9% (3/7)
38.9% (7/18)
42.9% (6/14)
25.0% (3/12)
28.6% (4/14)
31.3% (5/16)
44.4% (4/9)
70.0% (7/10)
73.3% (11/15)
46.2% (6/13)
88.9% (6/9)

13. Any obstacles/challenges?
Time constraints
Movement of Staff/ Agency Staff
Leadership on ward
Availability of stakeholders to attend meetings and progress with project work
No designated time allocated for project work

14. Key lessons? Collaborative working
Working within a designated time frame
Development of new skills
Networking
Staff motivated from Pilot Wards
Use of Board rounds
Communication, Care planning and Documentation