Providing End-of-Life Care within A&E Walls
Care Continuum
Care Process & Redesign
National Healthcare Innovation and Productivity Medals
National Healthcare Group
31 December 2021
To design a framework of care to meet the needs of patients who are at end of life and their families. Standardized care improved patient dignity, family satisfaction, and reduced avoidable transfers.
Year Submitted: 2021
Published Date: 31 December 2021
Tags: Care Continuum, Care Process ＆ Redesign, End-Of-Life Care, Palliative Care, Quality Improvement, Workflow Redesign, Value Based Care, Safe Care, Patient Satisfaction, Productivity, Cost Saving
About this Content
Aims
To design a framework of care to meet the needs of patients who are at end of life and their families.
Background
Managing actively dying patients in A&E was challenging due to lack of processes, tools, and appropriate environments. A collaborative framework aimed to provide dignified care for patients and families.
Methods
Created a Quiet Room with mood-setting decals, religious books, and dimmable lighting.
Made subcutaneous Fentanyl available in the A&E system.
Collaborated with Palliative Medicine for synergetic care plans and simple nursing checklists.
Phased implementation with monitoring of interventions.
Results
14 patients moved to the Quiet Room, averaging 5.5 hours spent.
3 patients passed away in A&E, and 7 passed on in the wards.
Improved family satisfaction and reduced admissions.
Nurses delivered better care with increased awareness and training.
Conclusion
Standardized care improved patient dignity, family satisfaction, and reduced avoidable transfers. Continued improvements ensure best outcomes.
Lessons Learnt
Collaborative teamwork and phased implementation allowed small yet meaningful changes. Palliative education for nurses and doctors drives sustainability.
Additional Information
Focus on staff education and national collaboration to scale end-of-life care solutions across emergency departments.
Keywords
End-of-Life Care, Palliative Care, A&E, Patient Dignity, Care Redesign, Quality Improvement, Nursing, Family Satisfaction, KTPH
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Healthcare Administration, Nursing, Medical |
Applicable Specialty or Discipline | Palliative Medicine, Emergency Medicine |
Project Lead(s) | Ranjeev Kumar |
Project Member(s) | Seet Huey Ying |
Connect with this contributor!
Dr Ranjeev Kumar - ranjeev.kumar@ktph.com.sg
Project Attachment
373_KTPH_NHIP_2021_Providing_End_Of_Life_Care_w_in_AnE_Walls_COMBINED.pdf