91 Enhancing the quality of out of hours telephone advice: A decision support tool for nursing staff

Abstract

Background The majority of hours in the week fall outside of ‘9 to 5‘ working hours and it is well recognised that all branches of care need to develop out of hours (OOH) services. The Ambitions for Palliative and End of Life Care Framework suggest that services should offer 24/7 access to their users and provide specialist advice day or night. This poses a challenge for many centres across the UK with currently no standardised approach. Reviewing OOH telephone calls received by our inpatient unit over two months identified a need to streamline and standardise specialist advice and improve staff confidence in managing these calls. This issue is relevant to all palliative care services. Method An established triage tool previously developed by the Gippsland Region Palliative Care Consortium was analysed. Differences in pathways of care or clinical approach were identified and addressed in light of both our national and local service. Interactive, small group education was provided to teach staff about the triage tool. Results Phase 1 - triage tool adapted and tailored to the specific set-up of our local service Phase 2 - Pre- and post-education questionnaires demonstrated increased confidence among all attendees Phase 3 - Next step to evaluate clinical impact Conclusion This work demonstrates a positive change achieved by adapting and modifying processes from other healthcare settings and is applicable to any specialist palliative care service where inpatient nurses provide OOH telephone advice. Further work is required, ideally as a multi-centre collaboration, to evaluate the clinical impact of the triage tool in ensuring access to specialist palliative care advice in accordance with the Ambitions for Palliative and End of Life Care Framework.