59 Improving use of electronic palliative care coordination systems for patients discharged from an acute hospital trust for end-of-life care

<h3></h3> Advance care planning (ACP) is a process where an individual’s needs and wishes regarding future care are discussed and recorded. Electronic Palliative Care Coordination Systems (EPaCCS) allow ACP documents to be shared/accessed across multiple healthcare teams, updated regularly and increase the likelihood that an individual’s needs and wishes are consistently respected across healthcare settings. For individuals discharged from hospital for end-of-life care (EOLC) in the community, use of EPaCCS maximises the chance that personalised care is provided and that this care is delivered in a preferred location. The designated EPaCCS for London is the Universal Care Plan (UCP). This project aimed to improve the proportion of patients discharged from an acute hospital trust for EOLC at home with a UCP. Multiple education sessions regarding ACP and the UCP were provided to the in-patient palliative care, gerontology, haematology and oncology teams. UCP sections were added to triage and discharge templates for the palliative care and gerontology teams. Fast-track Continuing healthcare (CHC) funding was used as a proxy for patients being discharged for EOLC. Data was collected retrospectively from Q2 2023/24 to Q1 of 2024/25 to assess proportion of patients discharged with fast-track CHC funding, who had a completed UCP. The quality of each UCP was also assessed. Of the 68 patients discharged with fast-track CHC funding, the proportion with a UCP increased from 33% in Q2 2023/24 to 75% in Q1 2024/25. UCPs consistently recorded important decisions including preferred place of care/death (91%) and CPR status (95%) however information regarding symptom management plans (54%) and other personalised wishes, including spiritual needs, (21%) were less likely to be recorded. Focused education and use of template prompts improved the proportion of individuals discharged with an EPaCCS record to guide EOLC, however the content focused on specific decisions rather than holistic needs and wishes.