’Did we do our best?’ Reviewing person-centred compassionate care at the end of life in an acute hospital in the United Kingdom, during the COVID-19 pandemic. An Appreciative Inquiry

Abstract

ABSTRACT There is an outstanding task for all international healthcare organisations to understand how healthcare services learn from the COVID-19 pandemic. We sought to understand whether the treatment and holistic care received by each person who died with presumed nosocomial COVID-19 in our United Kingdom hospital was provided with kindness and compassion. A multi-professional team carried out a service evaluation underpinned by Appreciative Inquiry (AI) methodology. Our current Learning from Death data collection tool was supplemented by the addition of narrative analysis to augment our qualitative findings. We identified a total of 63/143 patients as dying from presumed nosocomial COVID-19 in our hospital. The deaths occurred in hospital between 15 April 2020 and 29 January 2021. We found evidence of individualised decision-making in complex medical situations, alongside the challenge of managing COVID-19, with appropriate management of deterioration and appropriate symptom control. A Learning from Death programme benefits from a multi-professional approach that utilises the skilled workforce mix that exists in our hospitals. The use of AI methodology and addition of narrative analysis is practical and adds valuable qualitative data to the scrutiny of deaths. Sharing the narrative of those who died during the COVID-19 pandemic has reinforced the evidence that healthcare professionals strive to do their best even in the most challenging circumstances and do so with compassion.