31 Communication of palliative needs in discharge letters from hospice to primary care

Abstract

<h3>Introduction</h3> The provision of palliative care, including for those with complex palliative needs, is set to increase in the next twenty years, with most people dying in a community-based settings. Consequently, it is essential that interfaces between primary and secondary care are improved. A key element of improvement is ensuring effective communication of patient needs when moving between services, such as when patients are discharged from hospice or specialist palliative care. Past work has indicated that communication issues are prevalent during care transitions, but little is known about patients who are discharged from specialist palliative care. <h3>Aims</h3> To address the what, how or why gaps in the knowledge base of discharge from specialist palliative care and so contribute to improvements in the coordination of care from specialist to primary palliative care services. <h3>Method</h3> Our mixed methods study is made up of three parts: Examining discharge letters of 250 patients from five Marie Curie hospices across the UK. Focus groups with specialist palliative professionals. Knowledge translation workshops with Marie Curie stakeholders inclusive of clinicians, patient and public involvement representatives, and policy leads. The analysis draws on methods from the fields of Health Sciences and Applied Linguistics, namely, thematic analysis and corpus linguistics. <h3>Results</h3> Our study has generated insights into what constitutes complex needs and how some inequities in specialist palliative care may be addressed. Our results provide understanding of what patterns are associated with those discharged from specialist palliative care services and how palliative needs are communicated to primary care physicians. <h3>Conclusion</h3> This study makes recommendations for improving policy and guidance surrounding discharge communication from specialist palliative care to primary care. <h3>Impact</h3> Our study identifies important elements for discharge summaries which may be used to refine local discharge templates. The workshops will identify possible translation routes of the research findings into policy and practice.