bluuebunny/crossref_metadata_2025_split huggingface dataset:
P132 To admit or not to admit? – the use of a waiting list scoring system to prioritise admission requests
Authors: Hodgson Aruna 
Published: October 2013

The problemA hospice inpatient unit was receiving more requests for admission than it could meet. Patients who were felt to need urgent admission would tend to be offered a bed ahead of those whose need was thought to be less urgent. This could result in those with complex moderate intensity symptoms having to wait a considerable time for admission, leading to ongoing suffering and often an escalation in their needs.The attempted solutionA simple scoring system was introduced to assist with prioritisation. Referrers are asked to specify how urgently admission is required (Immediate = within 24 hours, Soon = within 3 days, Routine = within 5 days). Patients are allocated a score for priority of need and then accrue points according to each working day they are on the waiting list. When a bed becomes available, it is allocated to the patient with most points. When several patients have the same number of points and only one bed is available, the team discusses the relative needs of each patient to decide who will be offered the bed.The outcomeDespite training prior to the introduction of the scoring system, there was initially some inconsistency in the way referrers assessed urgency, with a number of patients being listed as “Immediate” inappropriately. Following further discussion and education, this has improved. The system now works well and although demand for beds often still exceeds availability, the system allows them to be allocated in a fair and equitable way and has reduced the time taken to decide which patient (s) will be admitted when there are several on the waiting list. The system has attracted interest from other local hospices who are struggling with the same problem of over demand for beds.
P133 “Not only but also” Establishing a first point of contact and triage service
Authors: O’Grady Jackie , Cottingham Laura , Linehan Gail 
Published: October 2013

BackgroundA South West London Hospice receiving around 900 referrals per year.First Point of Contact (FPC) service was established following identification of variation in response times for initial contact to arrange assessment.In collaboration, a Triage service provides immediate access to a Clinical Nurse Specialist (CNS) for advice, support and responsive emergency visits.AimsTo provide an efficient, responsive referral service.To provide accessible telephone support for patients, relatives and professionalsProvision of a responsive approach to requests for urgent home visits.Service configurationA team of three CNSs (WTE 2.2) covering 08:30-18:00 Monday-Friday.Referrals reviewed on receipt with responsive contactUrgent referrals initiate immediate FPC contact to assess and where necessary a same day visit by the triage CNS.Routine referrals assessed by telephone within 48 hours with first visit arranged within two weeksFPC attends weekly Palliative Care MDT meetings at both local hospitalsThe triage CNS offers telephone ‘help line’ advice and support to referred service users and professionals.OutcomesThree month pilot (17thDecember - 17thMarch 2013) compared to November 2012 demonstrated:70% improvement in response times to all referrals being contacted within 24hrs94% of urgent referrals contacted within 24 hours21% improvement in 2 week first visit76% of received calls completed by Triage CNS supporting the community team.A result of service questionnaire from relevant stakeholders is awaited.Implication to delivery of specialist palliative careBetter end of life management within the community through advice given to GPs at point of referral e.g. ensuring appropriate documentation and medications in placeImproved access to the hospice for referrals and adviceImproved response to referralsImproved communication, collaborative working and outcomes for patients.
P134 Pilot service evaluation survey to demonstrate ‘quality & efficiency’ of ‘hospice in-patient care’
Authors: Joseph Marie , Goldhill Alice 
Published: October 2013

IntroductionPatients with uncontrolled symptoms will experience impaired quality of life [QoL].Improvement in symptom management, therefore will lead to an improved ‘QoL’ which is one of the ultimate goals of management of patients in the palliative care setting.The ‘WHO performance scale/status’{PS}, is designed to measure the ‘QoL’ of patients in the above setting.It is measured between 0 and 4. [0---normal; 4---totally bed/chair bound, with gradations in-between]{Note: The higher the value of the ‘PS’, the lower the ‘QoL’ of the patient.}AimTo demonstrate improvement in ‘QoL’ following successful symptom managementMethodsSurvey all in-patient admissions to the hospice for ‘symptom control’ purposeIdentify symptoms on admissionRecord ‘PS’ as a measure of patient’s ‘QoL’,on admission & on dischargeRecord relevant clinical & therapeutic management measuresPilot survey period:Approximately 6 weeksResults14 patients were admitted for ‘symptom control purpose’.Neuropathic pain, poor pain control [commonest], nausea and vomiting, shortness of breath, anxiety/low mood, constipation were the identified symptoms.‘OPIOID switch’, Neuropathic Analgesic Agents, Continuous Sub-Cutaneous Infusion [CSCI/syringe driver], were the common therapeutic measures used.Average PS on admission was: 2.7 {approximately 3}Average PS on discharge was: 2.2 {approximately 2}All patients were discharged home with an improved ‘PS’ indicating an improvement in their ‘QOL’ in comparison to the state on admission.3 patients subsequently died at home.Discussion/Survey implicationsThis pilot survey demonstrates to the Clinical Commissioning Groups [CCGs], an evidence of ‘quality and efficiency of hospice in- patient care’.The findings in addition strengthen ‘staff morale’ in caring for patients in the hospice setting.ConclusionPS’ as a measure of ‘QoL’ can be a marker of good symptom management in palliative care.April 2013
P135 Pro-active approach to falls management
Authors: Bourne Jacqui , Newsam Cathy , Moorey Alison 
Published: October 2013

In common with many hospices, historically there has been a significant number of patient falls and this led to a team desire to take a proactive approach to falls management. A development group including user representation was set up with the aim of creating an individualised falls prevention care plan for use not only in the inpatient unit, but also in day-care and by the hospice at home team. This initiative was adapted from excellent work undertaken in Wales.The existing accredited moving and handling staff trainers were recruited as champions for the introduction of this initiative which included the development and usage of;Patient Falls Assessment ChecklistBed Rails Risk AssessmentFalls Prevention Care Plans andInformation leaflet entitled “Reducing patient falls”These initiatives above were supported by the use of an adapted manual handling traffic light system for patients who had recently fallen.The champions took an imaginative and creative approach to introducing this change by incorporating role play and case scenarios in their teaching plans.April 2009 to March 2010 Prior to initiativeApril 2010 to March 2011April 2011 to March 2012(high number of repeated fallers Jan/Feb)April 2012 to March 2013Falls not resulting in injury45194328Falls resulting in injury2318149The equipment costs of approximately £8,000 for bed and chair sensors, low beds and crash mats seem a very appropriate investment when considering the results of this initiative, shown in the table above, fall numbers fluctuate but are always lower than prior to the initiative and there is an impressive year on year reduction in the number of injuries sustained. The improvements not only contribute to the organisation’s strategic objectives to improve care and safety but assist in providing essential evidence to the Care Quality Commission too.
P136 Journey for Men - A support Group
Authors: Benson Kevin , Gillespie Dorothy 
Published: October 2013

The Journey for Men group was started to provide a safe place for men to explore their feelings.The group consists of men who have either lost a child or are facing the loss of their child.AimsTo provide a safe environment for men to openly discuss their feelings about their experiences of having a child with shortened life expectancy or losing a child.To encourage open discussion on life issues, family dynamics, coping strategiesTo encourage male friendships, social networking and an opportunity to feel a part of an informal support group.Approach UsedA person centred counsellor facilitates the group providing monthly sessions in the evening at an agreed time.Sessions are no more than two hours, unless a planned activity occurs. The sessions have no fixed agenda. Chip butties are provided as the men often arrive after work.Attendance is open ended which encourages growth but also allows men to move on.Once a quarter an activity is provided away from the hospice to encourage relationship building and social networking.To date the men have discussed very challenging issues such as:Support, caring and friendship among men.Facing and working on restrictive and destructive aspects of the male gender roleOpportunity to discuss supportive roles usually filled by women in the home and in professional settings.Attention to unfinished business with our fathers and contemplation of the ways we have related to significant men in our lives.OutcomesThe group is 2 years old and over 30 men have accessed this service and have reported the following changes as a result of attending the group:Increased coping mechanismsIncreased ability to talk about their feelings with their partnerGreater ease in discussing difficult issuesGreater ease in exposing vulnerability.Application to Hospice PracticeThis is a tried and tested model in engaging a hard to reach group, lessons learnt from this experience are transferable to other hospices.
P137 A Whole School Approach to Loss, Grief and Bereavements
Authors: Miller Jane , Lindsay Jacquie , Kelly Jane , Guthie Michelle , McCurrie Emily 
Published: October 2013

Many children and young people will experience bereavement, through the loss of a parent, sibling, grandparent, friend or pet. The term ‘bereavement’ refers to the process of grieving and mourning, and is associated with a deep sense of loss and sadness. It is a natural process; however its effects can be overwhelming.During bereavement, children and young people can experience a great number of emotions, including sadness, anger, anxiety, guilt, fear, denial, disbelief and confusion. With the right help and support, most children and young people will not require professional help. According to the Child Bereavement Charity, what they do need is people who care and the understanding of familiar and trusted adults. Schools are well placed to provide such support.A working group has been established with representation from GCC Education Services, Educational Psychology, NHS GG&C Health Improvement and Glasgow Hospice staff. The purpose of the group is to promote a planned and progressive approach to teacher training around supporting children and young people experiencing bereavement, loss and change in line with a Curriculum for Excellence, across educational settings to ensure consistency in relation to Bereavement & Loss. To support and equip staff to take forward learning around bereavement, loss and change with access to high quality resources and training. and to develop an online resource that can be updated as new information becomes available.To date two study days have been facilitated each with 30 delegates from a range of early years, primary secondary and special needs schools. The evaluations were extremely positive. Future study days are in the planning process with the aim that these days will be ran twice yearly for the foreseeable future. The online resource is complete with a launch date planned for Summer 2013.
016 Barnsley Hospice - “Mapping Our Communities”
Authors: Barnett Richard , Carey Ian , Conrad Laura 
Published: October 2013

Barnsley Hospice offers a broad range of services to an adult population of approximately 177,000 individuals across 127 square miles of the borough.As in many hospices, there exists a wealth of data that, if extracted, analysed and presented in the appropriate manner, has the potential to streamline operations, help focus valuable resource and improve outcomes across all areas. A recent move by the Local Authority to create six new ‘Area Councils’ with localised budget and decision-making responsibilities has been seen by the hospice as an opportunity to take a more focused approach on community engagement with a key aim being to extract and merge relevant data to deliver an overall ‘view’ of demographics, patient activity, fundraising and key stakeholders within each area.In order to engage with our communities, the hospice primarily needed to engage itself in the process and value of data. Data from different systems was cleansed, refined and combined into a single set and uploaded into the Google Fusion Tables product in order to display it visually on a Google Map. In addition to this, additional datasets were mined from public sites such as Health & Social Care Information Centre in order to enrich and validate the view. The map is layered, allowing various elements to be enabled/disabled according to what the individual viewer wishes to see.The opportunity to interact with data in a ‘visual’ way has realised several key outcomes with some specific examples including:Enhanced engagement in data across the hospiceIdentifying geographic areas that may need additional focus on patient referralsDefining targeted fundraising activityProducing an overall picture of activity across the different areasThe tools used are, at the time of writing, currently free for non-profits and can significantly assist hospices to realise the potential of the information they hold.
P138 Cooking with chris: The teenager programme
Authors: Brocklehurst Tania , Sears Gill , To Chris 
Published: October 2013

Strobe and Schut’s (1999), Dual Process Model suggests that a healthy grieving process involves oscillating between life restoration and grief orientation activities. Following the success of the Hospice of St Francis, 2012 bereaved adults “Cooking with Chris” programme, we developed a 5-week teenagers course. This is a difficult age group to connect with. Food was used as a therapeutic bridge. Vital cooking skills were learnt and the experience and feelings of loss and grief addressed.Bereaved teenagers between 11 and 18 years from the Hospice fortnightly ‘drop in’ took part. They had experienced the death of a close family member. Ideally, they attended with a significant adult.After introductions and a practical induction to the hospice kitchen, weekly themed menus such as ‘Amazing Mince’ and ‘Sausage Surprise’ were produced. Undertaking the course was not without its challenges. There were no existing guidelines. One aspect was the emotional impact on the facilitators. A robust debriefing process was crucial for promoting understanding and resilience in the course staff and volunteers. Further anxiety was overcome about teens messing around if bored and how to control such behaviour in a busy working kitchen, whereas the previous adult groups have been very noisy, the teens were relatively quiet, probably as they were so busy concentrating!Highlights included seeing the teens coming out of their shells and observing the parents working with the children. Parents found support in each other. Feedback commented how important it had been for their teen to come back to the hospice to do something enjoyable, adding positive memories to the sad ones she held of her Father dying there.We believe that this programme provides innovative bereavement support for teenagers in a therapeutic, meaningful and fun way. Guidelines for others doing similar have been produced.
P139 Building capacity and compassion: piloting a collaborative project to enable young people to support others who experience death, bereavement and loss
Authors: Archer Nikki , Owen Pat , Beckett Jane 
Published: October 2013

St Giles Hospice has worked in collaboration with a local secondary school to pilot a 1hour workshop for Year 8 pupils as part of their PSE programme. The work shop was accredited by Education Transformation, Staffordshire Education Authority and was facilitated by trained volunteers. Students were invited to create a young person through whom they were able to explore issues relating to death, bereavement and loss. Over 200pupils participated.Peer support is a key aspect of the support young people identify as being helpful in enabling them to adapt and cope with bereavement. Building capacity and compassion within our community is a key strategic aim.EvaluationA number of key themes were identified from the students feedback. The students felt it enabled them to:listen to each otherunderstand others feelingsrespecting differencetalk safely about death, bereavement and loss.understand the impact on the listenerOnly 5 students stated they felt they had gained nothing from the sessionThe facilitators feedback indicated that generally students were:engaged and eager to share their ideas and experiences.enabled to understand issues relating to death, bereavement and loss.enabled to identify how they might support a friend who had suffered a lossThe role of the teacher and the need for the practicalities to have been agreed was highlighted.Teachers feedback indicated that the workshop was well delivered, helpful and informative giving an opportunity for young people to understand the issues.The project forms part of the Hospice’s programme for building compassion and capacity within our local community. Additional opportunities for fundraising and volunteering were identified. We plan to build on the success of the project by exploring opportunities to work in partnership with other local organisations to deliver the workshops.
P140 Kylie, Jason, Chantelle and Jess: creating characters as a catalyst for change. Enabling the community to understand and meet the needs of young people experiencing loss and bereavement
Authors: Archer Nikki , Coleman Jenni , Rodgers Carol , Chetwynd Helen 
Published: October 2013

A collaborative project between St Giles Hospice and Lichfield District Safer Community Partnership was undertaken which aimed tobuild sustained confidence and capacity of community staff to enable them to help and support young people who are coping with loss and bereavement.For children and young people within our local community to be better supported and understood through their loss experiencesThere is strong evidence that bereavement and the changes that accompany it can make children and young people vulnerable to poor outcomes, particularly in disadvantaged circumstances. Many children and young people are able to accommodate and adjust to their loss if they receive the right help and support through their usual networks, however, those who work with young people tell us they feel ill equipped to support young people who have experienced loss and bereavement.During a half day workshop participants were afforded an opportunity to explore death, dying, bereavement and loss through the creation of a character based within their own experiences.Pre and post workshop participants were asked to rate how confident they felttalking to young people about death and dying?supporting a young person who has been bereaved?The results were very positive.58 attended94% assessed themselves with a higher post workshop score, the average score increased from 5 to 8 for both questions. All valuedthe workshop.A follow up focus group was held 9 months after the initial workshop. Feedback demonstrated the ripple effect the workshop had ona personal and professional level. There was evidence that the increased confidence had been sustained.This project demonstrates how the hospice is engaging with it’s local community to build capacity and better equip everyone in supporting young people experiencing loss and bereavement.
P141 A Review of The Multi Disciplinary Team’s (MDT) perception of the psychosocial services team’s (PST) intervention on the in patient unit (IPU)
Authors: Riley Martin 
Published: October 2013

This project considered how counselling is offered, accessed, received and perceived on the In-Patient Unit (IPU) at Hospice in the Weald. Questions were formed about adapting and modifying the existing service to better meet the needs of our service users.Unstructured interviews were held with professional MDT groups, inviting them to discuss perceptions of psychosocial care and how patients’ needs are met on the IPU. Sessions were audio recorded, transcribed and analysed.A new model of care was proposed. Counsellors rotated through IPU for 6 weeks. At the end of the rotations, each counsellor was interviewed, as was the larger MDT (in one collective group). Interviews were recorded and salient learning points identified. After each rotation, questionnaires were given to IPU staff to identify the benefits, things to change and give feedback.We learned that traditional methods of referral, assessment and practice of counselling are inappropriate to the specialist setting of in-patient care. Questions about ownership of psychosocial care, referral processes, multidisciplinary aspects of collaborative working, audit/review and IPU admissions for psychological care were asked and partially answered in the study. Interviewing staff after the change in practice revealed much more satisfaction with the counselling service and many advantages arising from the change in practice. Improved MDT working and speed of access to counselling were cited most frequently.The wider implications include considering how we modify our practice to better meet the needs of our service users. Working differently may lead to investigations about what we call this approach to the provision of psychological support to in-patients and their relatives. For some it’s still counselling, for others it’s an exciting challenge to expand both their practice and capacity to offer support to those facing the end of a life; particularly those who otherwise reject talking therapy.