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Sharing Current Scottish Practice

Poster abstracts of the month: September

The SPPC Annual Conference in 2019 featured 32 poster displays, sharing work and research underway across Scotland. Each month, this blog focuses on the content of a few of these posters. This month, we focus on:

Service Evaluation of Key Information Summary (KIS) Completeness and Changes over time for Patients Referred to Community Specialist Palliative Care Services

Author(s) Libby Sampey, Dr Juliet Spiller, Dr Anne Finucane

Background: KIS, an electronic palliative care coordination system, enables unscheduledhealthcare providers access to key clinical information to guide care out of hours. This project aims to determine whether KIS is complete for appropriate patients and how it alters over time.

Methods: This was a service evaluation reviewing patient case notes, including KIS documentation at referral and one-month post-referral. Additionally, semi-structured interviews with Palliative Community Nurse Specialists (CNSs) explored KIS usefulness.

Results: 77% of patients had a KIS at referral. One-month post-referral, all had a KIS and 59% contained updates. At referral, 53% of KISs stated there was an anticipatory care plan (ACP) in place, 50% specified a DNACPR decision and 24% noted preferred place of care or death. Carer details were available in 29% of KISs. CNSs find ACP the most useful aspect of KIS and proposed more ACP detail in updates. One recommendation suggested to improve this was allowing CNS access to update KIS.

Conclusion: The majority of new referrals to palliative services had a KIS at referral and all rereviewed had one at one-month post-referral. Areas of potential development include improving KIS accessibility for CNSs and putting in place future systems allowing CNSs to edit KIS.

Song writing for grief and loss: An intergenerational project between hospice patients and primary school children

Author(s) Giorgos Tsiris, Donna Hastings, Becky Chaddock, Stephen Fischbacher, Margaret McLarty

In 2019, as part of its expanding community engagement and health promotion work, the Arts and the Family Support services of St Columba’s Hospice implemented an innovative project raising death and dying awareness.

This project, which was co-led by St Columba’s Hospice and Fischy Music, took the form of an intergenerational song writing project. Hospice patients and children from Victoria Primary School were brought together to explore, express and share through music their experiences of grief, change and loss in life. Their collaborative work was subsequently shared with the public through recordings of the songs and live performances which attracted public and media attention. The project also included training for all school staff and school-wide workshops raising awareness and equipping people with the resources to cope creatively with loss change and grief in life. In this poster we outline some key processes and outcomes of the project alongside illustrative materials such as photos and direct quotes by the participants. Looking ahead, we also consider the implications of the project and discuss future developments. This includes the role of hospices as a resource hub for the local community fostering partnerships and opportunities for open dialogue and creative action around death, dying, change and loss.

SPARC – Supportive and Palliative Action Register in the Community

Author(s) Dr Melanie Sloan, Susanne Gray, Vicki Cloney, Dr Katie Clark

A previous partnership with Macmillan Cancer Support aimed to redesign community based palliative care in Renfrewshire. This led to the testing of SPARC - Supportive and Palliative Action Register in the Community. Key outputs included developing:

  • weekly MDT meetings (WISeR)
  • a social prescribing model for individuals with a palliative condition whose support needs are stable.

This led to a year-long partnership with Healthcare Improvement Scotland to test ways to more effectively identify people who would feed into these services.

A key shift in thinking was to establish a way to identify people who would benefit from the social prescribing arm of the SPARC approach. This led to the development of a ‘new’ GP question to identify people much earlier. The old ‘surprise question’ is still helpful for identifying people approaching the end of their life; however, our aim is to facilitate early palliative care.

Through our work with GP practices it was apparent that there are a wide variety of approaches to managing palliative care registers and meetings. Therefore, we have developed a new ‘SPARC’ register format that supports both identification and discussion of these individuals. The register can be shared with other practices should they wish to use it.

SPOT - The Safer Prescription of Opioids Tool Deployment in Clinical Practice

Author(s) Roger Flint, Geraldine Finnan, Annabel Howell

The Chief Medical Officer for Scotland invited all clinicians to innovate and disseminate innovation throughout the NHS.

The Safer Prescription of Opioids Tool, SPOT, is a novel software medical device designed to improve the safety of opioid conversion in Palliative and End-of-life care in all settings and for all prescribers.

It was developed over the course of five years with a multi-professional and interdisciplinary team. SPOT’s initial release version is complete and it is undergoing adoption and roll-out Board-wide in NHS Borders.

This poster outlines the key steps and activities required to disseminate and foster adoption of an innovative software medical device throughout an NHS Health Board in Scotland. It identifies the key barriers to adoption and the methods and mechanisms to overcome these blocks. This process includes stakeholder engagement, project planning and initiation and a communications and dissemination plan to spread SPOT throughout the NHS Board, leading to the adoption of the innovation in the Health Board.

This spread and sustainability framework was used to inform the process and learning from this pilot and could be used to encourage and spread the dissemination of other innovative tools in NHS Health Boards (Healthcare Improvement Scotland 2013).

The Truacanta Project – Helping Each Other with Death, Dying, Loss and Care

Author(s) Caroline Gibb, Mark Hazelwood, Rebecca Patterson

The Truacanta Project will support local communities across Scotland who are interested in taking community action to improve people’s experiences of death, dying, loss and care. It is a three year initiative being run by Scottish Partnership for Palliative Care and funded by Macmillan Cancer Support.

Communities have an important role to play in supporting people through the difficult times associated with ill health, dying, loss and care, but in many ways, have become ill-equipped to provide this supportive role. The international compassionate communities movement shows an appetite for change; in Scotland there are many individuals and groups keen to find ways to enhance compassion in their own communities, who bring with them skills or experiences that have the potential to be hugely beneficial.

Using a community development approach, The Truacanta Project aims to mobilise these assets - the strengths, knowledge, experience, skills and resources that already exist - to nurture compassionate communities in Scotland.

This poster will help delegates understand the background to and aims of The Truacanta Project, what we mean by a community development approach, and the vision for how the project and participating communities will develop.

Tracing Autonomy: a reflective approach in support of autonomy in life

Author(s) Dr Ben Colburn, Jeni Pearson, Kirsty Stansfield

Tracing Autonomy is a collaboration between the Art Team at PPWH and Philosopher Dr Ben Colburn, University of Glasgow & End of Life Studies Research Group. Tracing Autonomy offers a systematic way of reflecting on practice that is appropriate, efficient and focussed.

It offers a 4-step process that can be tailored and adapted to practice and in relation to the patient. It is not a form to fill in but instead offers a reflective framework for thinking about how to support a patient’s autonomy in life and to identify what might undermine the autonomy of a patient.

This poster will describe the framework, including its use of an expanded holistic terrain. The terrain takes into account the physical, psychological, social and spiritual aspects of a person’s life. It also considers the environment, quality of dialogue and sensory experiences that a person may have. We will present the four characteristics of autonomy (choice, value, relationships and authorship) that can be used to identify and understand what has undermined or supported a person’s autonomy. This reflective process allows the practitioner to engage in meaningful and purposeful dialogue with the individual and begin working towards alternatives and in some cases the ideal.

Welcoming the public to St. Columba’s Hospice on Edinburgh Doors Open Day

Author(s) Danuta Orlowska, Karen Filsell, Giorgos Tsiris, Suzie Stark, Maggie Young

Doors Open Day is one of Edinburgh’s popular free days out when members of the public can explore some of the city’s fascinating buildings. Though our doors are open throughout the year, taking part in Doors Open Day is an opportunity to locate our community engagement work within a city-wide event. Participation enables us to share our vision and values in a relaxed and informal way. As well as seeing our buildings and interior design, visitors can talk to staff and volunteers and find out about what we offer: services for patients (inpatient, day therapies and community), opportunities for supporting the hospice (working and volunteering in a variety of ways) and the education and research in which we are involved.

The poster presents information about our participation in Edinburgh Doors Open Day

  • planning behind the scenes
  • selected highlights of our participation
  • some of the feedback we have received.

Participation in Edinburgh Doors Open Day is now an established part of our calendar and we look forward to welcoming visitors on Saturday 28 September 2019 (11.00 – 15.00).

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