Presentation on a short training project and supporting materials for GPs and other health professionals proven to boost confidence and improved end of life care. From Hilary Fisher and Lorna Potter from England's Dying Matters coalition as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011.
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Dying Matters: Feel the fear, and have the conversation anyway
1. Feel the Fear - Learning from Dying Matters Conversation Pilots Hilary Fisher Lorna Potter Director, Dying Matters Community Development Adviser Dying Matters and NCPC
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9. Intervention Workshops for GPs Communication skills training GP involvement in developing a suite of communications materials to support conversations about end of life
10. Methodology Data collection GP Questionnaire (pre and post pilot) Patient Questionnaire Conversation and Action Record Sheet Death Audit
11. Type of illness Diseases and circumstances in patients, family members and carers with whom GPs discussed end of life
12. Stage of illness Stage of disease and circumstances in patients, family members and carers with whom GPs discussed end of life
13. Conversation triggers The triggers for 155 conversations with patients, family members and carers when GPs discussed end of life
16. Change in GP confidence Change in all GPs’ self-rated confidence in starting and having conversations pre and post pilot May 2010 ( n = 46) Sept 2010 ( n = 53)
NCPC the umbrella charitable body for palliative care: Influences government policy; Supports all sectors involved in providing, commissioning and using hospice and palliative care services; Promotes palliative care for all; Provides guidance on best practice Members of Dying Matters include: NHS, voluntary and independent health and care sectors, including hospices, care homes, charities supporting old people, children and bereavement, from social care and housing sectors, faith organisations, community organisations, schools and colleges, academic bodies, trade unions, the legal profession and from the funeral sector Our members are working together to encourage people to talk about their wishes including where they want to die and their funeral plans with friends, family and loved ones
We ran a 4 month project with 24 GP practices – 59 GPs - participating - Support GPs in their conversations with patients & relatives about dying/death - Pilot communications materials that will assist GPs in communications with patients & relatives and the utility of the materials from a patient perspective in initiating and assisting with discussions about death, dying and bereavement.
The evaluation included: GPs GP assessment of the utility and usefulness of the materials developed to help with : -Initiating appropriate conversations -Having approximate conversations GP views on the design of materials The numbers of people with whom GPs have initiated conversations. GP confidence / willingness to initiate conversations GP confidence whilst having conversations Patients Patient’s views on the helpfulness of material used by GP. Patient’s views on the helpfulness of patient directed material. Patients views on the design of materials.
In 27 of the 155 conversations, DNAR was both discussed and recorded in the patient’s notes.
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