61 First intensive care unit to achieve gold standards framework accreditation: reviewing impact for patients and collaborative working

<h3>Background</h3> There is no single approach to integrating Specialist Palliative Care on intensive care units, despite the knowledge that between 15–20% of those admitted die during that admission. In 2023 the Intensive Care Unit at the Dudley Group NHS Foundation Trust (DGFT) became the unit to achieve Gold Standards Framework (GSF) accreditation, and a review was conducted to look at the impact accreditation has had for end-of-life care outcomes. <h3>Methods</h3> Retrospective evaluation using patient electronic records to review all deaths on intensive care between 01/01/21 and 31/12/23; include pre-accreditation and post-accreditation data. <h3>Results</h3> There was an increase in the proportion of patients identified and coded with GSF following accreditation, with 16.1% of all admissions to Intensive Care were identified and coded in 2023 with a similar proportion identified in 2022 (17.6%). The number of deaths on intensive care identified as either GSF Red or Amber increased from 14.5% to 57.8% by 2023. Since accreditation there has been a sustained increase in the total proportion of patients identified as either Green or Amber offered an ACP, from 14.8% in 2021 to 36.8% by 2023. The number of individual patients referred to Specialist Palliative Care also increased, from 9.6% of all deaths in 2021 to 20.4% of deaths on intensive care by 2023. There was a greater number of direct discharges from intensive care to a dying patients preferred place of care, including home and hospice. <h3>Conclusion</h3> Gold Standard Framework accreditation in intensive care has had a positive impact on enabling identification of patients in the last year of life whilst improving collaborative working with Specialist Palliative Care.