3027 Identifying and coding patients appropriate for the Gold Standard Framework on discharge from an inpatient gastroenterology ward

Abstract

Background A third of hospital inpatients may be in their last year of life and over the past 25 years there has been evidence to show the Gold standard Framework (GSF) reduces hospitalisation and allows more people to live and die in their preferred place of care. Teams undertaking GSF find admissions and lengths of stay are significantly reduced. Our inpatient ward did not have processes to identify those appropriate for the GSF. Aim To identify and code patients appropriate for the gold standard framework on the inpatient gastroenterology ward at Salford Royal. Methods Baseline data was collected, standards were set and data was collected from March 2024 to July 2024 by retrospectively reviewing documentation. Using the PDSA cycle format; the first intervention carried out was an education session. The second intervention was a poster and flow diagram. Other data collected was valuable such as whether the hospital palliative inpatient team had been involved, if advanced care planning discussions had been had and whether community palliative care were informed on discharge. Results Of the 36 patients admitted in the first 2-week period the 11 patients who had a GSF eligible diagnosis were not identified or coded. Following the first and second interventions made 21 further patients were identified as eligible for diagnosis on data collection but no GSF coding was carried out or documentation on the discharge letter. Conclusion The two interventions received positive feedback and engagement however it did not lead to patients being coded. The patients who were reviewed in the Specialist liver disease palliative care MDT (SILP) had referrals placed to the community palliative care team and advanced care planning initiated. Our recommendation was to consider implementing a bundle that suggests referral to the SILP and within the bundle asks for the GSF to be coded.