TY - JOUR
T1 - Advance care planning and end-of-life care in a network of rural Western Australian hospitals
AU - Auret, Kirsten
AU - Sinclair, Craig
AU - Averill, B.
AU - Evans, Sharon
PY - 2015
Y1 - 2015
N2 - © 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.
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.
U2 - 10.1111/ajr.12167
DO - 10.1111/ajr.12167
M3 - Article
C2 - 26131742
VL - 23
SP - 195
EP - 200
JO - The Australian Journal of Rural Health
JF - The Australian Journal of Rural Health
SN - 1038-5282
IS - 4
ER -