'Round the Room - Updates and Information Sharing' (From Acute Hospital Network, March 2015) [AHN 33]

1. Round the Room.
Updates & Information Sharing
23/06/2015 1

2. EduEthics. Research Project
The Irish Hospice Foundation, in partnership with University College Cork is
pleased to open a call for participants in a research project to pilot and
evaluate an educational intervention involving the Ethical Framework for End
of Life Care Study Sessions.
Click here to read the background information about this project.
Please note the closing date for applications is Friday 03 July 2015.
Click here to download the application form.
For informal enquiries please contact Orla Keegan,
Head of Education, Research & Bereavement at the Irish Hospice
Foundation on 01-6730049 or orla.keegan@hospicefoundation.ie
23/06/2015 2

3. St Luke’s Hospital, Kilkenny
Solace Room, Maternity Unit Before
23/06/2015 3

4. 23/06/2015 4
St Luke’s Hospital, Kilkenny
Solace Room, Maternity Unit
After

5. 23/06/2015 5
St Luke’s Hospital, Kilkenny
Solace Room, Maternity Unit

6. 23/06/2015 6
St Luke’s Hospital, Kilkenny
Solace Room, Maternity Unit

7. 23/06/2015 7
St Luke’s Hospital, Kilkenny
Solace Room, Maternity Unit

8. 23/06/2015 8
St Luke’s Hospital, Kilkenny
Solace Room, Maternity Unit

9. For more information contact:
23/06/2015 9
St Luke’s Hospital, Kilkenny
Solace Room, Maternity Unit
Mary Dowling
Clinical Risk Manager
St Luke's General Hospital
Kilkenny
056-7785137 / 087- 2329113
marybridget.dowling@hse.ie
Patricia Wogan
CNS Ultrasonographer
St Luke's General Hospital
Kilkenny
056- 778 5000
patricia.wogan@hse.ie

10. Think Ahead Information evening
UHL Nenagh Hospital. April 2015
23/06/2015 10
All hospital staff, GPs, PHNs,
Nursing Homes, Community
Hospitals, Practice Nurses &
Home Care Nurses in north
Tipperary invited.
Over 50 attendees on the night.
Dr Brendan O’ Shea guest
speaker.
IHF provided financial support

11. 23/06/2015 11
Think Ahead Information evening
UHL Nenagh Hospital. April 2015

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Think Ahead Information evening
UHL Nenagh Hospital. April 2015
Carmel Sheehy
CNS, Palliative Care
UHL, Nenagh Hospital
carmel.sheehy@hse.ie
Tel 067 42338 or 067 31491 Bleep 045

13. Beaumont Hospital Fundraising
23/06/2015 13

14. 23/06/2015 14

15. Beaumont Hospital
Conference
1 December 2015
Dying, Death & Bereavement: Opportunities &
Challenges.
Centre of Education, Beaumont Hospital.
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16. Beaumont
Hospital
Poster
23/06/2015 16
Contact Gill Rufli
End of Life Care Coordinator
Beaumont Hospital
gillianrufli@beaumont.ie
01- 8092768

17. Mater
Hospital
Fundraising
23/06/2015 17

18. Mater Hospital
Posters
23/06/2015 18
St Francis Hospice Kaleidoscope Conference
"Palliative Care Beyond Cancer: The Journey Towards
Inclusiveness” May 2015
http://www.sfh.ie/kaleidoscope
Contact Diarmuid Ó Coimín
End of Life Care Coordinator
Mater Hospital
docoimin@mater.ie 01-8032117

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Dying Matters in the Mater
Surveying bereaved relatives
Diarmuid Ó Coimín 1 , Grace O’Sullivan 2 , Mairead Curran 1
Mater MisericordiaeUniversity Hospital 1 , Irish Hospice Foundation2
Introduction & Research Evidence
Aim
Acknowledgements and References
Methods
43% of all deaths in Ireland occur in hospitals. 1
Several studies have reported on excellent end of life care
provided in acute hospital settings in Ireland, however,
others have found deficiencies.2,3 Measuring and
evaluating end of life care is vital to improving it.
Bereaved relatives are a vulnerable group however
surveying bereaved relatives is a well established method
of research.4
Relatives’ views are important because
• they play a vital role through their support and care
at this critical time of a patient’s life.
• they act as proxies for patients with evidence that
their evaluation of services matches those of
patients.
• relatives not only provide care at end of life, they
receive care and support from hospital staff.
• they can inform us about the care their family
member received as well as information on the care
and support they received at the time.
Bereaved relatives value the opportunity to provide
feedback in the knowledge that it contributes to
improvement in care.
Results and Next Steps
Narrative feedback from bereaved relatives generated
considerable interest among hospital staff. Relatives
described examples of excellence in care and areas
where improvement could be made including:
• involving patients more in decision-making and
direct communication about care.
• improve communication with families specifically
in relation to sensitively informing families that
death is imminent.
• improve facilities for families and the need to
accommodate dying patients in single rooms.
Outcomes from surveying bereaved relatives
Findings have been used in the Mater Hospital to
frame quality improvement initiatives and motivate
staff to build on existing good practices whilst
focussing on areas for improvement.
Conducting a bereaved relatives survey has
contributed to gaining a better understanding of the
experiences of patients and their families in the last
days of life.
To describe the methods used in a survey of
relatives whose family member died in the Mater
Hospital.
This research was conducted as part of a larger study- the National End of Life Care
Audit and Review System developed by the Irish Hospice Foundation and the National
Clinical Programme for Palliative Care.5 The study received research ethical approval.
The study included a review of the end of life care of 26 patients who died from April-
September 2012. Bereaved relatives were invited to participate as outlined here:
A special thank you to all the bereaved relatives who
participated in this study and shared their experiences.
References
1. Irish HospiceFoundation (2014), EnablingMore Peopleto Die at Home.
2. McKeown K., HaaseT., Pratschke J., Twomey S., Donovan H. & Engling F. (2010) Dying in
Hospital in Ireland: An Assessment of theQuality of Carein theLast Week of Life, Report 5,
Final Synthesis Report. Irish HospiceFoundation, Dublin.
3. Office of the Ombudsman (2014), A GoodDeath: A ReflectiononOmbudsmanComplaints
about End of Life Carein Irish Hospitals.
4. Office of National Statistics (2014), National Surveyof Bereaved People –VOICES. Crown
Publications, London.
5. Irish HospiceFoundation (2015), Hearing the Voice of Bereaved Relatives.
For more information contact: Diarmuid Ó Coimín. End of Life Care
Coordinator, Mater Hospital, Dublin docoimin@mater.ie
Three months after the death, 26 bereaved
relatives were invited by telephone by the
hospital’s End of Life Care Coordinator to
participate
26 deaths randomly selected from 8 clinical areas
Step 1
Survey pack sent to 23 relatives who agreed to
participate. Survey pack included: survey,
information letter & bereavement support leaflet
Step 2
Step 3 Final reminder and thank you letter sent to
participants two weeks later
15 completed surveys returned
Findings
The survey response rate was 60%.
Many relatives used the telephone call (step 1 above) as an
opportunity to speak about their experience of care in the hospital.
• Bereaved relatives felt valued by being invited to provide
feedback.
• Using a telephone call as a method of initial engagement
revealed the importance of capturing feedback from relatives.
• More than half of those telephoned provided informal feedback
by phone “I’ve told you everythingnow that I’d say in a survey”.
Telephone calls gave good insights into care experience, however,
also demanded considerable time.
May 2015
Anonymised feedback disseminated to hospital staff
Following on from this research, a large scale
joint research study is being carried out by the
Mater Hospital and St James’s Hospital. This
study involves surveying 800 bereaved
relatives.
“Thanksfor phoning… it’s goodto be
asked aboutthis … I hope I can be of
help”
“Thanksfor asking …it’s a
goodidea to get
informationfrom families
aboutour experiences”

20. 23/06/2015 20- McKeown K., HaaseT., PratschkeJ., Twomey S., Donovan H. & Engling F. (2010) Dying in Hospital in Ireland:An
Assessment of the Quality of Carein the Last Week of Life, Report 5, Final Synthesis Report. Irish HospiceFoundation,
Dublin.
-Brerton L., Gardiner L. , C. , Gott M. , Ingleton C. , Barnes S. & Carroll C. (2012) Thehospital environment for end of life
care of older adults and their families: an integrativereview. Journal of Advanced Nursing 68(5), 981–993
Williams C., Gardiner C., (2014) Preferencefor a singleroom in a UK inpatient hospice: patient family and staff
perspectives BMJ Supportive andPalliativeCare 2014 1-6
Enhancing Care at End of Life
Dying in a Single Room
Diarmuid Ó Coimín, Mary Day, Noreen Keane, Mairead Curran
Mater MisericordiaeHospital.
Introduction and Background
Research Evidence
Purpose / Aim
References
Implementation Strategy
Results
We set a target of prioritising and increasing the number of
patients allocated a single room at end of life. We developed and
started measuring data for this KPI in 2010. Since then we have
consistently achieved or exceeded our target from 45% in 2010
to achieving 78 % in 2014 , see Figure 1. Data is reviewed and
evaluated on a month by month basis with stakeholders. Data
for 2014 is presented in Figure 2 . The Mater Board of Directors’
receive a monthly Quality Dashboard and report on quality of
clinical care indicators. This is one of the quality indicators on
this dashboard.
43% of all deaths in Ireland occur in hospitals. Our goal as a hospital
is to endeavour to ensure that patients who die in our care
experience a place of sanctuary, where they die in comfort and
dignity and their families are supported in their bereavement.
The physical environment of hospitals can enhance or detract from
dignity and care of patients and their families at end of life. The
National Audit of End-of-Life Care in Hospitals in Ireland (2010)
corroborates international research on the significance of care at end
of life being provided in single rooms and their importance in
improving care outcomes at this time
Context : There are a number of competing demands that determine
the allocation of single occupancy rooms within an Acute Hospital in
Ireland. Patient need, income generation, infection control and the
limited availability of single rooms all determine single room
allocation.
The National Audit of End-of-Life Care in Hospitals in Ireland (2010)
found that 15 % of all hospital beds were in single rooms, with 44% of
deaths occurring in single rooms. The Mater had 12% of hospital
beds in single rooms with 45% of deaths occurring in single rooms.
The National Audit also found that single rooms are:
consistently associated with better care outcomes in the
assessments of nurses, doctors and relatives.
Symptom management is better and team meetings are more likely
to be held
Quality of staff communication with relatives is better
Single rooms also:
Afford patients dignity and greater privacy
Offer staff more personalised patient contact which can reduce
patients anxiety
Improve comfort and allow greater interaction with visitors
Allow patients personalise space with mementos of significance
from home in the last days of life, enhancing emotional wellbeing
Reduction in noise levels with ’peace’ and ‘quiet’
Privacy when meeting health care professionals
Facilitates more accessible visiting for relatives
Enables relatives to stay overnight and be present at the moment
of death if they wish
 Support patients preference. Research has indicated that some
patients prefer a shared room for social contact, however,
preference changed to a single room when seriously ill or close to
death
Conclusion
Increase the
number of
people cared
for in single
rooms at end
of life
Plan
Do
Study
Act
More people die in hospitals than in any other care setting.
Research indicates significant improvements in care outcomes may
be obtained if care at end of life is provided in a single room.
Our results shows the significant improvements we have made
since 2010.
This project is an excellent example of a hospital team working
together to improve care outcomes for patients nearing end of life
and their families.
• Identify Key stakeholders
• Highlight Data from Audit & Research
• Set KPI for 2010 = 50%
• Ensure Executive Management
support
Plan
• Identify Champions e.g. ward based
staff, Bed Management
• Create awareness about KPI
• Develop capacity to capture data (IT-
Support)
Do
• Review data monthly
• Report findings to all key stakeholders
including Champions, Executive
Management and Board of Hospital
Study
• Audit Indicator & celebrate success
• Discuss , review and act when KPI not
met (where possible)
• Publicise initiative and increase KPI
each year
Act
Taking account of individual patient preference and clinical needs, a
key performance indicator (KPI) was developed to ensure more
patients and their families are cared for in single rooms at end of
life.
Key stakeholders worked together to achieve our aim. Deming's Plan-
Do-Study-Act (PDSA)Cycle was utilised as the method of improvement.
Figure 1
Figure 2
Deming's PDSA Cycle

21. 23/06/2015 21
Acknowledgements / References
Room to Improve
Creating family rooms on acute hospital wards
Diarmuid Ó Coimín, Doreen Steenson, Mairead Curran
Mater Misericordiae University Hospital
Background
43% of all deaths in Ireland occur in hospitals. Our goal as a hospital is to endeavour to ensure that patients who die in our
care experience a place of sanctuary, where they die in comfort and dignity and their families are supported in their
bereavement.
Research conducted on the conditions of the environment in Irish acute hospitals in 2007 identified that there was a “lack
of facilities for private consultations and conversations in situations where confidentiality is paramount “ and also found
that there was a “lack of facilities for families and family rooms” (Tribal 2007). Feedback from patients and their families
has also suggested the need to have family rooms on busy acute wards.
Process / Implementation
Results
• A special thanks to the Irish Hospice Foundation and
their work with the HSE on Design and Dignity who
funded the first project and inspired this initiative.
•Thanks to the Mater Foundation and all hospital staff
for their ongoing support.
References:
Tribal Consulting Design and Dignity Baseline Review (2007).
Design and Dignity Guidelines(2008) , Irish Hospice Foundation .
Design and Dignity Style Book (2014), Irish Hospice Foundation ,
available online at : www.designanddignity.ie
For more information contact:
Diarmuid Ó Coimín. End of Life Care Coordinator, Mater
Hospital, Dublin docoimin@mater.ie
The first refurbished family room was opened in April 2012, since then three more family rooms have been completely
refurbished, with four more to be completed in June 2015. Creating warm, comfortable, non-institutional family rooms is
possible in an acute hospital setting.
The specification of the rooms was developed through the initial projects and there is now a standard family room layout.
The success of the rooms has generated enthusiasm and a need from other ward areas to have a family room on their ward.
This project is an excellent example of a hospital team working together to improve the environment for patients nearing end of
life and their families.
St John’s ward Family Room St Brigid’s ward Family Room St Vincent’s ward Family Room
Photographs
following
refurbishment
Photographs of
rooms
before
refurbishment
Feedback
• Ward areas were identified based on need
• Project teams were developed consisting of ward based staff, clinical staff and staff from the estate and facilities projects team
•Staff involved patients and their families in the design and colour selection of the rooms
•Funding was sourced through various sources, staff organised coffee mornings, cake sales & raffles and grant applications were made.
“The family room is a wonderful
addition to the ward, there was
nowhere to relax when I was here- the
pictures are beautiful and a great
addition to the room. Well done on all
the great work”
“You can get
away from it all in
here”
“It’s great that you can make a cup of tea
without having to interrupt the nursing
staff - who are so busy”
“The Sleepover sofa in the family room
allowed me be close to Dad in the nights
before he died – its invaluable ”
“This room lifts
my mood”
As one Clinical Nurse Manager noted “we are
keen to move away from the practice of “breaking
bad news and informing patient of a poor
prognosis, which happens on corridors and six
bedded bays,which as we all know are not
conducive to patientprivacy,it’s a thing of the
past now that we have a family room”.
“The artwork in the
family room
distracts me from
my worries”
“We've met other families in this
family room who are in a similar
situation as we are. We could
share our experiences it's been
a great support”
•To enhance and improve the physical environment for the care of persons at the end of life including their families,
•To assess and evaluate existing family rooms and where necessary refurbish to ensure a consistent standard.
•To develop family rooms where none exist.
•To develop core criteria for family rooms.
Aims
May 2015

22. Connolly Hospital
Poster
23/06/2015 22
Contact Sorcha Bennett
End of Life Care Coordinator
Connolly Hospital
sorcha.bennett@hse.ie
(01) 646 5000
In 2007 Connolly Hospital joined the Hospice Friendly Hospitals (HFH) Programme.
HFH is a partnership initiative between the Irish Hospice Foundation and the Health Service
Executive to improve end-of-life care for patients and their families.
In 2010, Connolly Hospital introduced the role of End-of-Life Care Coordinator.
The role of the End-of-Life Care Coordinator is to support a hospital-wide end-of-life care quality
improvement programme.
A hospital-wide end-of-life care quality improvement programme
For more information contact: Sorcha Bennett, A End-of-Life Care Coordinator sorcha.bennett@hse.ie
Key Achievements
Governance
The End-of-Life Care Committee in reports to the senior
management team and oversees the implementation of
the Quality Standards for End-of-Life Care. Chaired by
the Director of Nursing Judy McEntee and co-chaired by
ADON Patricia Meade.
The Committee has four workstreams aligned to the
HFH Quality Standards for End-of-Life Care; The
Hospital, The Staff, The Patient & The Family.
The End-of-Life Care Coordinator is a key member of
this committee and supports each workstream.
The Hospice Friendly Hospitals Programme
Connolly Hospital
Staff Confidence & Competence
Connolly Hospital provides staff training in End of Life
Care through the Final Journeys Training. This one day
facilitation session is aimed at all levels of staff and its
purpose is to reinforce the principles of the Hospice
Friendly Hospital Programme, identify the excellent
practice that currently exists and encourage the
continuity and expansion of this practice.
This year a new programme will be run called the
Palliative Care Needs Assessment Training. This
training will focus on the skills needed by health care
professionals to assess individuals’ Palliative Care
Needs based on the Palliative Care Needs Assessment
Guidance, a document launched in July 2014.
Design & Dignity
Enhancing the environment for patients and their
families.
The Blanchard Family Room’s toilet facilities has been
renovated & funding was awarded to Connolly from
the IHF for the Bluebell Room. This room is
specifically designed for breaking bad news and
bereavement counselling.
Education snapshot
Programme Attendance
Final Journeys 49 Staff
Key Performance Indicator (KPI)
Privacy & Dignity for Patients
Audit underway on the use of single rooms at end of life
Symbolic resources are used throughout the hospital
The end of life symbol is placed at
the nurses station to signal that a
patient has died.
Dignified bag for returning
deceased patients property.
On average over
300 people per year
die in Connolly
Hospital.
That’s 5 people per
week.
Bluebell Room . Funded by the IHF/HSE Design & Dignity
Grants Scheme

23. Final Journeys.
Facilitator Training @ the IHF
Monday 24th of August – Final Journeys workshop
For anyone who would like to become a facilitator but has not yet
been on Final Journeys.
Tuesday 25th of August – Final Journeys facilitator development
training.
For more information contact: Claire Banks
Irish Hospice Foundation
claire.banks@hospicefoundation.ie
01-679 3188
23/06/2015 23

24. European Association for Palliative Care
9-11 June 2016
World research congress coming to Dublin
Abstract submission deadline:
15 October 2015.
http://www.eapcnet.eu/research2016/
23/06/2015 24

25. Marymount University Hospital and Hospice International
Conference on Palliative Care and Care of the Older Person
15- 17 October 2015
23/06/2015 25
http://www.marymountconferencecork.ie/
Abstract submission deadline:
30 June 2015

26. Coming soon….
Subject guide for Palliative & End-of-Life Care
• Part of a suite of subject guides on topics like patient safety, quality & standards, mental health and public
health to be added to the HSE website.
• A broad collection of the best sources & resources on the topic including Irish & international material.
• Curated by Laura Rooney-Ferris. Information & Library Manager, Irish Hospice Foundation
01 6755975 Laura.RooneyFerris@hospicefoundation.ie
http://hse-ie.libguides.com/
23/06/2015 26