Advance care planning and end-of-life care in a network of rural Western Australian hospitals

Kirsten Auret, Craig Sinclair, B. Averill, Sharon Evans

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

© 2015 National Rural Health Alliance Inc. Objective: To provide a current perspective on end-of-life (EOL) care in regional Western Australia, with a particular focus on the final admission prior to death and the presence of documented advance care planning (ACP). Design: Retrospective medical notes audit. Setting: One regional hospital (including colocated hospice) and four small rural hospitals in the Great Southern region of Western Australia. Participants: Ninety recently deceased patients, who died in hospitals in the region. Fifty consecutive patients from the regional hospital and 10 consecutive patients from each of the four rural hospitals were included in the audit. Interventions: A retrospective medical notes audit was undertaken. Main outcome measures: A 94-item audit tool assessed patient demographics, primary diagnosis, family support, status on admission and presence of documented ACP. Detailed items described the clinical care delivered during the final admission, including communication with family, referral to palliative care, transfers, medical investigations, medical treatments and use of EOL care pathways. Results: Fifty-two percent were women; median age was 82 years old. Forty percent died of malignancy. Median length of stay was 7 days. Thirty-nine percent had formal or informal ACP documented. Rural hospitals performed comparably with the regional hospital on all measures. Conclusions: This study provides benchmarking information that can assist other rural hospitals and suggests ongoing work on optimal methods of measuring quality in EOL care.
Original languageEnglish
Pages (from-to)195-200
JournalAustralian Journal of Rural Health
Volume23
Issue number4
DOIs
Publication statusPublished - 2015

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Advance Care Planning
Rural Hospitals
Terminal Care
Medical Audit
Western Australia
Insurance Pools
Benchmarking
Rural Health
Hospices
Palliative Care
Length of Stay
Patient Care
Referral and Consultation
Communication
Demography
Outcome Assessment (Health Care)
Neoplasms

Cite this

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abstract = "{\circledC} 2015 National Rural Health Alliance Inc. Objective: To provide a current perspective on end-of-life (EOL) care in regional Western Australia, with a particular focus on the final admission prior to death and the presence of documented advance care planning (ACP). Design: Retrospective medical notes audit. Setting: One regional hospital (including colocated hospice) and four small rural hospitals in the Great Southern region of Western Australia. Participants: Ninety recently deceased patients, who died in hospitals in the region. Fifty consecutive patients from the regional hospital and 10 consecutive patients from each of the four rural hospitals were included in the audit. Interventions: A retrospective medical notes audit was undertaken. Main outcome measures: A 94-item audit tool assessed patient demographics, primary diagnosis, family support, status on admission and presence of documented ACP. Detailed items described the clinical care delivered during the final admission, including communication with family, referral to palliative care, transfers, medical investigations, medical treatments and use of EOL care pathways. Results: Fifty-two percent were women; median age was 82 years old. Forty percent died of malignancy. Median length of stay was 7 days. Thirty-nine percent had formal or informal ACP documented. Rural hospitals performed comparably with the regional hospital on all measures. Conclusions: This study provides benchmarking information that can assist other rural hospitals and suggests ongoing work on optimal methods of measuring quality in EOL care.",
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Advance care planning and end-of-life care in a network of rural Western Australian hospitals. / Auret, Kirsten; Sinclair, Craig; Averill, B.; Evans, Sharon.

In: Australian Journal of Rural Health, Vol. 23, No. 4, 2015, p. 195-200.

Research output: Contribution to journalArticle

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AB - © 2015 National Rural Health Alliance Inc. Objective: To provide a current perspective on end-of-life (EOL) care in regional Western Australia, with a particular focus on the final admission prior to death and the presence of documented advance care planning (ACP). Design: Retrospective medical notes audit. Setting: One regional hospital (including colocated hospice) and four small rural hospitals in the Great Southern region of Western Australia. Participants: Ninety recently deceased patients, who died in hospitals in the region. Fifty consecutive patients from the regional hospital and 10 consecutive patients from each of the four rural hospitals were included in the audit. Interventions: A retrospective medical notes audit was undertaken. Main outcome measures: A 94-item audit tool assessed patient demographics, primary diagnosis, family support, status on admission and presence of documented ACP. Detailed items described the clinical care delivered during the final admission, including communication with family, referral to palliative care, transfers, medical investigations, medical treatments and use of EOL care pathways. Results: Fifty-two percent were women; median age was 82 years old. Forty percent died of malignancy. Median length of stay was 7 days. Thirty-nine percent had formal or informal ACP documented. Rural hospitals performed comparably with the regional hospital on all measures. Conclusions: This study provides benchmarking information that can assist other rural hospitals and suggests ongoing work on optimal methods of measuring quality in EOL care.

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