P-136 Evolution of a hospice virtual ward through collaboration – 365 days later

<h3>Background</h3> St Columba’s Hospice Care established a Virtual Ward offering daily face-to-face medical and nursing assessment, care and support. A 3-month pilot evaluation evidenced the positive impact of the service. Areas for improvement were around information sharing and communication with primary and secondary care teams and timely access to medication. <h3>Aims</h3> To implement quality improvements following liaison with team leads in primary care, secondary care and pharmacy services. <h3>Methods</h3> <i>Primary Care</i>: Standardised email correspondence with GPs of Virtual Ward patients. Instituted daily meetings with district nursing and Marie Curie out of hours teams. Enabled Virtual Ward Doctors to certify death in the community and developed a communication pathway with GPs. GP practices sent detailed Virtual Ward information via their Update Bulletin. Information about the Virtual Ward and how to refer was placed on NHS Lothian RefHelp online resource for primary care teams. <i>Secondary Care</i>: Established weekly hospital palliative care online meetings. <i>Pharmacy services</i>: Identified network pharmacies to increase stocks of relevant medications and established clear communication systems between pharmacy teams to manage stock. Implemented a new hospice policy to enable Virtual Ward staff to collect and carry prescriptions and medications when other options were not available. <h3>Results</h3> Primary care measures have improved information sharing, enabled joint visits, facilitated joint planning of discharge from Virtual Ward to primary care and created clarity in death certification. Secondary care measures have enabled shared planning of patient discharge to the Virtual Ward, increased collaboration and peer support networks. Identification of, and referrals of patients to the Virtual Ward have resulted from both. Network pharmacies have increased availability of medications which, alongside improved GP communication and enabling Virtual Ward staff to collect and carry prescriptions, has improved timely access to medication for patients. <h3>Conclusion</h3> Working with partner teams has facilitated improved communication networks, increased referrals and improved access of vital medication for Virtual Ward patients.