Introduction of the Liverpool Care Pathway for end of life care to emergency medicine

Paterson, Brodie; Duncan, Russell A.; Conway, Rosie; Paterson, Fiona; Napier, Pamela; Raitt, Merritt H.

doi:10.1136/emj.2008.067249

Cited by 30 publications

(46 citation statements)

References 8 publications

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“…This might explain why, although nursing staff were able to recognise dying in our study, they needed confirmation from senior medical staff. Many other studies have described the positive attitudes of nursing staff towards EOL care pathways, in particular the LCP,17 but this is the first time an EOL tool has been described as having a role in empowering nursing staff to approach the bedside of a dying patient.…”

Section: Discussionmentioning

confidence: 93%

Healthcare professionals’ perspectives on delivering end-of-life care within acute hospital trusts: a qualitative study

Reid¹,

Gibbins

Bloor

et al. 2013

BMJ Support Palliat Care

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Section: Discussionmentioning

confidence: 93%

Healthcare professionals’ perspectives on delivering end-of-life care within acute hospital trusts: a qualitative study

Reid¹,

Gibbins

Bloor

et al. 2013

BMJ Support Palliat Care

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“…1) having a dedicated facilitator to provide training and ongoing support on the hospital ward about the benefits and goals of the LCP [45-47], 2) training and ongoing education on why and how to use the pathway, for nurses, and especially physicians [45-48], 3) the organization of an audit and of feedback opportunities [45, 47], 4) having a central coordinating LCP office to support local LCP facilitators [49] and, 5) funding, and time for efforts such as facilitation, education, and training [45, 46]. …”

Section: Resultsmentioning

confidence: 99%

Development of the care programme for the last days of life for older patients in acute geriatric hospital wards: a phase 0–1 study according to the Medical Research Council Framework

et al. 2015

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BackgroundThe effects of the Liverpool Care Pathway (LCP) have never been investigated in older patients dying in acute geriatric hospital wards and its content and implementation have never been adapted to this specific setting. Moreover, the LCP has recently been phased out in the UK hospitals. For that reason, this study aims to develop a new care programme to improve care in the last days of life for older patients dying in acute geriatric wards.MethodsWe conducted a phase 0–1 study according to the Medical Research Council Framework. Phase 0 consisted of a review of existing LCP programmes from the UK, Italy, and the Netherlands, a literature review to identify key factors for a successful LCP implementation and an analysis of the concerns raised in the UK. In phase 1, we developed a care programme for the last days of life for older patients dying in acute geriatric wards based on the results of phase 0. The care programme was reviewed and refined by two nurses and two physicians working in an acute geriatric ward and by two experts from Italy and the Netherlands.ResultsPhase 0 resulted in the identification of nine important components within the LCP programmes, five key factors for a successful LCP implementation and a summary of the LCP concerns raised in the UK. Based on these findings we developed a new care programme consisting of (1) an adapted LCP document or Care Guide for the older patients dying in an acute geriatric ward, (2) supportive documentation, and (3) an implementation guide to assist health care staff in implementing the care programme on the acute geriatric ward.ConclusionsBased on the existing LCP programmes and taking into account the key factors for successful LCP implementation as well as the concerns raised in the UK, we developed a care programme for the last days of life and modelled it to the acute geriatric hospital wards after gaining feedback from health professionals caring for older hospitalized patients.

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“…It has been reported that the real challenge for ED physicians is to be certain of the appropriateness of placing patients on such pathways [52, 57, 67, 110]. A modified version of this instrument known as the Modified LCP was implemented and validated in the ED in the UK, to investigate its applicability in the ED environment [52].…”

Section: Resultsmentioning

confidence: 99%

A Literature Review on Care at the End-of-Life in the Emergency Department

Forero

McDonnell

Gallego

et al. 2012

Emergency Medicine International

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The hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In addition, the escalating costs of providing care at the end-of-life in acute hospitals are unsustainable. Hospitals in general and emergency departments in particular cannot always provide the best care for patients approaching end-of-life. The main objectives of this paper are to review the existing literature in order to assess the evidence for managing patients dying in the emergency department, and to identify areas of improvement such as supporting different models of care and evaluating those models with health services research. The paper identified six main areas where there is lack of research and/or suboptimal policy implementation. These include uncertainty of treatment in the emergency department; quality of life issues, costs, ethical and social issues, interaction between ED and other health services, and strategies for out of hospital care. The paper concludes with some areas for policy development and future research.

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Introduction of the Liverpool Care Pathway for end of life care to emergency medicine

Abstract: It has been a rewarding undertaking to improve the care of dying patients, but one which has taken time and has required consistent management of change to promote the positive outcomes.

Cited by 30 publications

References 8 publications

Healthcare professionals’ perspectives on delivering end-of-life care within acute hospital trusts: a qualitative study

Healthcare professionals’ perspectives on delivering end-of-life care within acute hospital trusts: a qualitative study

Development of the care programme for the last days of life for older patients in acute geriatric hospital wards: a phase 0–1 study according to the Medical Research Council Framework

A Literature Review on Care at the End-of-Life in the Emergency Department

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