bluuebunny/crossref_metadata_2025_split huggingface dataset:
P51 Six steps + widening the access to good EOL care
Authors: Wilson Gail , Hine Paula , Talbot Judith 
Published: October 2013

The Six Steps + project aimed to create a local hospice accredited EOL quality kite mark to support local health and social care providers build their knowledge, skills and confidence in delivering EOL care. The project built on previous work by the North West and includes additional assessments and workshops on dementia and learning disabilities. The project was supported by Burdett Nursing Trust and local commissioners who wanted to see improved standards of EOL care.The Six Steps + programme has been running for the last 12 months and currently has 66 organisations and 131 individuals registered. The programme has been very successful and has delivered real service improvements eg the last post death audit (412 deaths), demonstrated that 42% of individuals who died had an Advance Care Plan in place and the number of inappropriate hospitals admissions fell from 40% to 23%.The project truly promotes integrated working. The hospice equality mark is now published in the local authority’s online public directory. Organisations stated they wanted to have a local quality mark linked to the local hospice which families recognise. The EOL Link Forum is pivotal to service integration as well as being a vehicle for ongoing audit and monitoring end of life outcomes.The programme does not provide any educational credit therefore Skills for Care was approached to accredit the programme. This resulted in a national mapping tool being created to map the Six Steps to the new Quality Credit Framework EOL qualifications.The next step for the project is to create a train the trainer programme to help others implement Six Steps + in their area. Hospices cannot provide all EOL care and they have an important role in enabling providers in their communities to deliver good quality equitable EOL care for all.
P52 Quality End of Life Care for All (QELCA©)
Authors: Bryan Liz , Cooper Marie , Hayes Anita 
Published: October 2013

The Department of Health has concluded that the non-specialist workforce needs to develop the necessary attitudes and skills in order to deliver consistently high quality care for people approaching the end of life and is looking for beacons of best practice in relation to practice development initiatives (DoH, 2008).St Christopher’s Hospice has designed a training programme which not only role-models end of life care to the participants but equips and empowers them to deliver better care to patients on their return to practice. QELCA© was designed to be delivered by hospice nurses to nurses working in hospitals. Teams of acute nurse clinical managers from the same department spend 5 days based at the hospice in small groups of three or four. Using the hospice setting as a learning resource, nurses are offered a first-hand experience of observing and being alongside specialist nurses as they care for patients at the end of life. In addition to this practice experience the 5-day programme combines classroom discussion and reflection facilitated by experienced specialist palliative care nurses. The programme then continues with six months facilitated Action Learning Sets (ALS) so that action plans for self, team and organisation, formulated by the participants on the final day of their hospice experience, can be supported in practice and learning from the programme consolidated.In partnership with St Christopher’s and Help the Hospices, the National End of Life Care Programme (NEoLCP), through the Transform Programme (NEoLCP, 2013), piloted QELCA©across 17 sites. 21 hospices were involved and a total of 137 acute nurses attended the QELCA©programme. Evaluation data were collected at four stages across the pilot timeline using mixed methods comprising, survey questionnaires, semi-structured questionnaires and focus groups. A report outlined the findings and made recommendations for the further development of the programme.
P53 Quality End of Life Care for All [QELCA] Leeds
Authors: Speight Laura , Lawman Steve 
Published: October 2013

IntroductionSt Gemma’s Hospice and Leeds teaching hospitals trust are involved in a national end of life care programme’s pilot. This is an education initiative called ‘Quality End of Life Care for All’ [QELCA] developed by St Christopher’s hospice.AimsShare expertise of Hospice care with nurses working in a variety of settings where End Of Life Care [EOLC] was being provided.Empowerment of generalist nurses to make a difference in practice, providing EOLC.Address with nurses issues of anxiety, fear, and lack of insight/self-awareness when providing EOLC.Equip nurses to remain in meaningful emotional contact with patients/relatives whilst preserving professional integrity.Prevention of emotional exhaustion and risk of ‘burn out’.Methods5 days placement at St Gemma’s Hospice.Combination of facilitated classroom learning and practical experience. [IPU, Community, Day services.]Reflect on learning and formulate action plan for priorities for change.Action plan is supported by facilitated action learning [AL] over six sessions.ResultsPositive relationships/ networks between acute and hospice staff.Constructive comments made regarding EOLC provision in different clinical areas.Each QELCA candidate focusses on something to change/ implement within clinical practice based on Hospice experience.During AL sessions, progress discussed/ action plans made. Changes occurred, with management support.DiscussionAttendance and feedback from the course is so far very positive, candidates enjoyed being in the different environment. AL sets not well attended therefore criteria could be changed for future courses. Results from AL are positive showing that changes had been implemented and worked in practice.Conclusion/ Future recommendationsSince the introduction of the DoH’s End of life care strategy 2008, there has been a focus on patients’ wishes at end of life especially on Preferred Place of Care, [PPC]. Courses such as QELCA, enable healthcare professionals to expand their knowledge in such a specialist area and provide such care through a process of innovation and change.
P54 Improving domiciliary end of life care through the development and evaluation of a specialised programme for domiciliary care organisations
Authors: Partington Lynne 
Published: October 2013

Background/ContextWithin the UK, there is a drive to reduce the number of hospital deaths thus potentially increasing end of life care in the community. However, there has not been a corresponding increase in the numbers of professional health care workers, so organisations such as domiciliary care agencies are providing more complex care and support for very ill patients in their own homes. This is an emerging role for these organisations so they need development, education and support to provide quality end of life care.AimThe ‘Six Steps to Success’ programme was originally developed to enable nursing homes to implement a structured organisational change to enable the delivery of the best end of life care. The programme has been adapted for use with domiciliary care agencies, involving a multi agency approach to developing the programme.Approach usedA pilot programme with four different organisations was pioneered, with the organisations participating both as learning organisations and evaluation partners. The pilot programme was evaluated both pre and post programme using three tools: Quality Markers, Post Death Information (PDI) and a Knowledge, Skills and Confidence audit.OutcomesThe results have established an increase in the quality of end of life care through a number of means, ranging from early identification of patients at the end of life through to improved communications with other agencies. Qualitative data has also been captured which demonstrates real life impacts and changes.Application to PracticeSupporting domiciliary agencies to care for the increasing number of patients requiring end of life care in their own homes has often been provided by hospices and their education departments. However, education alone is often not enough to make the changes required within an organisation and this programme can influence more extensive changes through a structured and systematic approach.
P55 Palliative Care Master Class Series for GP’s
Authors: Debbie Ho , Tredgett Dr Kate , Beckhelling Jill 
Published: October 2013

IntroductionA key strategic priority for the Hospice is extending the reach of its influence to more people facing the end of life. Key to this is its collaboration with GPs across its community. Following a needs assessment, an alignment with the local Education Trust (SET) was formed and a bespoke Master Class Series for GP’s developed. SET is the local coordinator and communicator of education for 170 GP members.AimsYear 1: 30% GPs to attend at least 1 session and 10% to attend 2 or more.Over 3 year period for 70% GPs to attend at least 1 session and 40% to attend 2 or more.MethodA rolling programme of three 2 hour educational sessions commenced in 2012:‘Amitriptyline to Zomorph via Oxycodone and beyond’ - Successful pain management in palliative care‘Managing your 1%’ - How to optimise care for your patients in the last year of life including advance care planning, DNAR, and services available to support GP’s.‘Achieving a successful home death’ - The ‘how to’ guide for general practitioners including syringe driver conversions, just in case medications, ethical dilemmas and services availableSessions were designed to be cumulative with concepts revisited and developed to reinforce learning. Case based and interactive, sessions provided opportunities for sharing experience, questions and reflection. Sessions ran on several occasions, and were free of charge.ResultsSessions were evaluated using a ‘reaction’ feedback form. Two months after the course GPs were sent a structured impact assessment form on which to provide an account of one occasion when they have applied the knowledge acquired during the course. Completing part 2 of the evaluation extended CPD credits from 2 to 4 per session.The target attendance for year 1 has been exceeded and evaluation by GPs has been excellent.
P56 Recording voices. Why is oral history important in palliative care and bereavement?
Authors: Winslow Michelle , Smith Sam , Betteley Adrienne , Noble Bill 
Published: October 2013

Oral history is the recording of unique life experience; it captures and preserves voices and participants are involved in the process of producing their own life histories. An oral history service for patients has run successfully in the Sheffield Macmillan Unit for Palliative Care since 2007. In 2012, with Macmillan Cancer Support we embarked on a project to develop oral history in pilot sites in the north of England and Northern Ireland. Evaluation of these services will determine whether oral history as a service will be rolled out nationally.Oral history complements palliative care services, it offers time to reflect, record identity and make a family record in the teller’s voice. A motivation for recording life stories can be the opportunity to create a family record. Oral history interviews are carried out by trained volunteers. Participants receive an audio CD soon after their interview and recordings are securely archived. With consent, interviews are available for research.To understand the role of oral history in palliative care and bereavement, a further 12 month project is assessing the impact of creating an oral history. We have analysed an existing archive of 200 oral histories and sought views from participants, family and friends via semi structured interviews and a questionnaire. Results are contributing important insights into the meaning of oral history for people who make recordings, and for those who receive them.Findings from both projects offer vital academic information to support the future shape and direction of Macmillan oral history services. We are establishing that oral history enhances patient experience of palliative care by providing opportunities to reflect and express identity in a non-medical context. Especially valuable is the existence of a voice recording for family and friends in bereavement.
P57 Developing an oral history service in a hospice
Authors: Williams Clare , Park Judith 
Published: October 2013

Background/contextThis poster describes the development and implementation of an oral history service at St Luke’s Hospice in Sheffield. Oral history involves an interviewer questioning and recording an interviewee. The service was modelled on a successful service at a local palliative care centre.AimPatients using the hospice’s day centre and in-patient unit would be offered the opportunity to make an audio recording of their life story. Patients would receive a copy of their story on CD and extra copies would be available to their family and friends with the patient’s agreement.Approach usedThe service started with a pilot where two patients took part in an interview and then gave feedback. This was positive and so the service was launched. Initially, a member of staff who was a trained oral historian conducted the interviews, but demand for the service led to 20 volunteers being recruited to carry out the interviews. Volunteers were trained in areas such as interview technique, use of recording equipment, ethics, and working with seriously ill patients.OutcomesTo date, 29 patients have used the service and 48 interviews have been recorded. Some patients have used the service to record final messages for family, and one has made a ‘Desert Island Discs’ style recording complete with music. Others have produced photo books to accompany recordings. The hospice is now able to offer the service to patients looked after at home by our Community nurses. It continues to receive positive feedback from patients and their relatives.Application to hospice practiceThe service’s model could be used by other hospices to set up their own oral history service. The hospice is also participating in a research study which aims to provide empirical evidence as to the benefits of oral history in palliative care.
08 Care, Compassion and Generosity: Building models of hospice care in diverse and resource poor communities
Authors: Robey Simon 
Published: October 2013

Background and ContentPeople with palliative and end of life care needs are dying for change. Therefore “to allow people the deaths they want, end of life caremustbe radically transformed” Garber and Leadbeater (2010).AimDevelop models of compassionate communities allowing greater access to social and therapeutic hospice services.Approach UsedOrganisational collaborative working with the inception of a Task & Finish Group.A questionnaire to find out what satellite services people want and where they want those services delivered.Discussion groups in GP surgeries, community centres, carers groups and existing support groups.Analysing the 165 returned questionnaires. The data will inform the direction of the initial pilot project.OutcomesDevelop a community based service supported by volunteers.Recruit, train and supervise a voluntary Empowered Living Team (ELT) to support hospice professionals in delivering care in the community through initiatives such as hand massage, physiotherapy rehabilitation programmes, supporting people to practice mindfulness techniques in their own homes with the support of a CD of relaxation techniques, guided meditations.The satellite will also offer a space for bereavement services to establish a community presence and a greater resource for the Community Palliative Care Teams (CPCT) to refer patients and family to.Application to Hospice careWe will demonstrate how by increasing access to hospice services through a compassionate community model more people will be able to:Discuss preferred place and type of care they receivePlan for their preferred place of deathReduce the fear of accessing hospice services such as planned respite, outpatient servicesThrough community support decrease the amount of emergency admissions to A&EIncrease the chances of families experiencing a well-planned and a good death.Access a greater variety of services by more partnership working.
P58 Real world hospice research: challenges and opportunities
Authors: Russell Sarah , Chadwick Sharon , Hodell Kate , Barbara Miller , Nmeth Erzsi , Taylor Ros , McLaughlin Kimberley , Woodwark Cate 
Published: October 2013

Compassionate evidence-based practice, collecting data and building evidence is fundamental to hospice care. The Hospice of St Francis research strategy provides areal worldpragmatic effective approach to research evidenced based care in a medium sized hospice.ChallengesResearch governance and credibility as a small organisationTime to reflect, discuss and put into practice evidenced based careBeing a Researcher Practitioner in the workplaceRealistic research with Universities and other research organisations.Using research to disseminate and influence care beyond the hospice wallsSolutions and OpportunitiesResearch strategy, governance and register of all research, audit and service evaluation activity reported to Clinical Governance and Clinical Leads forum.Collaborative research and governance with Institutes of Higher Education and individual researchers wanting to access our hospice as a research site.Research Interest Forum: 2 monthly multi professional forum to discuss issues as researchers in practice and evidence based practice clinicians.Journal Club: Quarterly forum to discuss articles of interest and relevance to practiceThink Tank: Monthly multi professional forum to share feedback from conferences and practice initiatives.Case and Care Reflections: monthly forums reflecting on clinical care.Clinical Nurse Specialist Continuous Professional Development Programme: 2 monthly forum delivered by Associate Specialist in palliative care.Schwartz rounds to stimulating discussion and reflection about carePublications and dissemination strategy.A shared passion for real world research.“Hospices must meet a range of challenges: collecting better data, developing a better understanding of those who needs will dominate future decades, and establishing a robust evidence base for new services” (Calanzani 2013). The Hospice of St Francis whole system approach to real world research makes a difference to care and offers possibilites for other similar sized organisations
P59 ENTER - Enabling nurses to engage in research: developing a culture of enquiry in clinical environments
Authors: Broadhurst Debra , Brown Jayne 
Published: October 2013

BackgroundIdentifying the importance of research in end of life care and fostering a culture of enquiry is a key step for healthcare providers if they are to move forward in addressing some of the challenges highlighted by the End of Life Care Strategy (DH, 2008). The ENTER project recognises the need to enhance the ability and confidence of nurses to engage in research activity and view it as an integral part of clinical practice to ensure high quality care at life’s end.AimsEmpowerment of senior nurses to guide their teams on research processesEstablish a network of support across the regionDevelop a web-based resourceEncourage clinical teams to embed a research culture in their working environmentsApproach usedSeven senior nurses (band 6 and above) attended a three day workshop which comprised of a mixture of taught sessions on the research process, sharing examples of research practices, introducing the ‘human face’ of teams such as Research and Development and Ethics Committees and reveiwing currently available resources.OutcomesThe group of nurses quickly established themselves as a support network for each other and although the project was originally time limited, a Community of Practice is being explored with support from Macmillan. Quarterly meetings have been planned for the next year with the aim of keeping the momentum going in each of the nurses clinical environments. A web based resource is being developed that will support nurses to foster a culture of enquiry, develop their own research practices and enable others to engage in research activity.Application to hospice practiceTwo nurses work specifically in hospices and are currently developing ward based projects to enhance the frontline staffs ability to participate in research. Others work in CNS roles and on wards in the acute sector and are looking at how they can further develop and encourage colleagues to become involved in the research process in some way.
P60 The experience of recruiting hospice patients, family members and health care professionals to a qualitative research study
Authors: Perry Rachel , Orlando Rosanna , Coast Joanna , Armour Kathy 
Published: October 2013

BackgroundA single patient recruitment site hospice and local university partnership has been established for a European Research Council funded research study. It aims to assess the validity of a supportive care measure in patients receiving end of life care, people close to them (CPs) and primary healthcare professionals (HCPs). The recruitment targets are 35 patients, 20 CPs and 20 HCPs. A hospice nurse (HN) identifies participants prior to recruitment by university researchers.AimTo establish successful patient recruitment in a hospice new to research.Approach UsedThe HN liaised with the multidisciplinary team (MDT) to identify eligible patients and provide support; she also approached all eligible patients in her own area of practice, day services. Facilities (e.g. interview rooms) were organised for researchers to recruit and interview participants.OutcomesTo date, 22 patients have been introduced to the study by the HN and given a patient information leaflet. 6 patient follow-ups are pending and 3 interviews have been booked. 5 patients have been recruited from Day Hospice. With permission from patients, 2 CPs and 4 HCPs have been interviewed.Challenges affecting recruitment include environmental issues (moving hospice); ethical issues (amendment required); poor health status of patients and their cyclical involvement in daycare.Remedies include (i) dialogue with patients and staff reducing concerns about the research nurse’s potential conflict in duties; (ii) communication reducing the reluctance of staff to “over-protect” patients and allow recruitment; (iii) extension of participants to community and IPU patients improving recruitment rates; (iv) adaptation of patient management system to administer interactions for research.Application to Hospice PracticeOur study explored methods of recruitment of patients to research. Improvements include communication of goals with hospice colleagues and university researchers and a growing confidence in approaching patients. Recruitment experience will change practice in this and future studies.