The feasibility, sustainability and impact of embedding the AMBER care bundle at a tertiary cancer centre.

Background: The AMBER care bundle facilitates earlier conversations with patients and their family about uncertain recovery and has been validated in acute hospitals. However, this tool has not been reported in a tertiary cancer setting to date.

Aim: Determine the feasibility and impact of embedding the AMBER care bundle within a tertiary cancer centre.

Method: The AMBER care bundle was launched in 2020 at a tertiary cancer centre, facilitated by a rolling education programme, digital tools and designated clinical leadership. Confidence with communicating uncertainty was collected pre- and post-training and clinical outcomes for patients supported by the AMBER care bundle were compared between baseline and 3 years post implementation.

Results: Trainees' confidence in communicating uncertainty was statistically significantly improved following training (P<0.01). Patient outcomes improved, including achievement of preferred place of death, which increased from 8 to 80% over 3 years. The AMBER care bundle is feasible and effective when implemented within a tertiary cancer setting.