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Fast-track hospital end-of-life discharge pathway: is it actually fast? National clinical audit

Fast-track hospital end-of-life discharge pathway: is it actually fast? National clinical audit
Fast-track hospital end-of-life discharge pathway: is it actually fast? National clinical audit

Objectives: to determine adherence to Department of Health and Social Care target of fast-track pathway discharge for end-of-life care within 48 hours. 

Methods multicentre audit in England using retrospective analysis of patient records for fast-track pathway tools submitted between 1 March 2019 and 31 March 2019. 

Results: most patients (72%) were not discharged within the 48-hour target. There was significant variability in success between hospital sites. Delays in discharge were most frequently considered to be secondary to delays in sourcing packages of care and 24-hour care facility placements. Involvement of specialist discharge nurses in paperwork submission improved rates by Commissioning Care Groups. Patients who died in hospital had significantly longer admissions than those who were discharged (discharged 19 days (IQR 11–28) vs died 28 days (IQR 18–42); p=0.039). This was entirely accounted for by increased numbers of days between admission and first suggestion of fast-track pathway discharge in those who died in hospital (discharged 9days (IQR 5–19), died 15 days (IQR 9–33); p=0.003). 

Conclusions: we demonstrated a delay in the fast-track pathway discharge process with significant variation in success of the discharge process at different geographical locations.

2045-435X
90-93
Goujon, Marie
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Osuafor, Christopher N.
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Rose, Alexander
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Jelley, Benjamin
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Hilarious, Amy
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Hubert, Charlotte E.
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Saprunova, Darja
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Alsahab, Mustafa
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McGinley, Abi
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Seed, Adam
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Nakeshree, Shailesh
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Thomas, Philip
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Forster, Micaela F.
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Currie, Hannah
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Jacques, Holly
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Madden, Katy
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Nicolson, Philippa
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Rajcoomar, Shalini G.
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Moreland, Jane
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Moriarty, Lizzie
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Magill, Laura
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McCluskey, Lauren
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Pettitt, Michala
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Pinkney, Thomas
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Cox, Natalie
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Geriatric Medicine Research Collaborative
Goujon, Marie
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Osuafor, Christopher N.
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Rose, Alexander
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Jelley, Benjamin
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Hilarious, Amy
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Hubert, Charlotte E.
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Saprunova, Darja
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Ladlow, Emma
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Gaunt, Victoria
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Dani, Melanie
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Lochlainn, Mary Ni
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Soo, Chee
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Richardson, Sarah
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Sleeman, Isobel
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Fairclough, Hannah
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Whitehouse, Sarah
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Wilcox, Sophie
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Alsahab, Mustafa
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McGinley, Abi
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Alexandra Timperley, Timperley
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Willott, Ruth H.
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Patterson, Katherine
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Pigott, Jennifer
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Khan, Asma
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Seed, Adam
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Grubb, Anthony
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Holmes, Elizabeth A.M.
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Janagal, Sureena
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McNeela, Natalie
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Nakeshree, Shailesh
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Thomas, Philip
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Vedutla, Tarunya
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Forster, Micaela F.
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Currie, Hannah
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Jacques, Holly
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Madden, Katy
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Nicolson, Philippa
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Rajcoomar, Shalini G.
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Moreland, Jane
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McCluskey, Lauren
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Moorey, Hannah
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Perry, Rita
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Pettitt, Michala
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Pinkney, Thomas
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Cox, Natalie
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Geriatric Medicine Research Collaborative (2022) Fast-track hospital end-of-life discharge pathway: is it actually fast? National clinical audit. BMJ Supportive and palliative care, 14 (1), 90-93. (doi:10.1136/bmjspcare-2021-003183).

Record type: Article

Abstract

Objectives: to determine adherence to Department of Health and Social Care target of fast-track pathway discharge for end-of-life care within 48 hours. 

Methods multicentre audit in England using retrospective analysis of patient records for fast-track pathway tools submitted between 1 March 2019 and 31 March 2019. 

Results: most patients (72%) were not discharged within the 48-hour target. There was significant variability in success between hospital sites. Delays in discharge were most frequently considered to be secondary to delays in sourcing packages of care and 24-hour care facility placements. Involvement of specialist discharge nurses in paperwork submission improved rates by Commissioning Care Groups. Patients who died in hospital had significantly longer admissions than those who were discharged (discharged 19 days (IQR 11–28) vs died 28 days (IQR 18–42); p=0.039). This was entirely accounted for by increased numbers of days between admission and first suggestion of fast-track pathway discharge in those who died in hospital (discharged 9days (IQR 5–19), died 15 days (IQR 9–33); p=0.003). 

Conclusions: we demonstrated a delay in the fast-track pathway discharge process with significant variation in success of the discharge process at different geographical locations.

This record has no associated files available for download.

More information

Accepted/In Press date: 19 September 2021
e-pub ahead of print date: 12 January 2022

Identifiers

Local EPrints ID: 497157
URI: http://eprints.soton.ac.uk/id/eprint/497157
DOI: doi:10.1136/bmjspcare-2021-003183
ISSN: 2045-435X
PURE UUID: f0cc1b65-9615-4d31-81d5-9e6d2447c287
ORCID for Natalie Cox: ORCID iD orcid.org/0000-0002-4297-1206

Catalogue record

Date deposited: 15 Jan 2025 17:31
Last modified: 20 May 2025 17:42

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Contributors

Author: Marie Goujon
Author: Christopher N. Osuafor
Author: Alexander Rose
Author: Benjamin Jelley
Author: Amy Hilarious
Author: Charlotte E. Hubert
Author: Darja Saprunova
Author: Emma Ladlow
Author: Victoria Gaunt
Author: Melanie Dani
Author: Mary Ni Lochlainn
Author: Chee Soo
Author: Sarah Richardson
Author: Isobel Sleeman
Author: Hannah Fairclough
Author: Debbie Fraser
Author: Victoria Gregg
Author: Sarah Whitehouse
Author: Sophie Wilcox
Author: Mustafa Alsahab
Author: Abi McGinley
Author: Ghayth Sandouka
Author: Timperley Alexandra Timperley
Author: Ruth H. Willott
Author: Katherine Patterson
Author: Jennifer Pigott
Author: Asma Khan
Author: Adam Seed
Author: Anthony Grubb
Author: Elizabeth A.M. Holmes
Author: Sureena Janagal
Author: Natalie McNeela
Author: Shailesh Nakeshree
Author: Philip Thomas
Author: Tarunya Vedutla
Author: Micaela F. Forster
Author: Hannah Currie
Author: Holly Jacques
Author: Katy Madden
Author: Philippa Nicolson
Author: Shalini G. Rajcoomar
Author: Jane Moreland
Author: Lizzie Moriarty
Author: Laura Magill
Author: Lauren McCluskey
Author: Hannah Moorey
Author: Rita Perry
Author: Michala Pettitt
Author: Thomas Pinkney
Author: Natalie Cox ORCID iD
Corporate Author: Geriatric Medicine Research Collaborative

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