WS09.9 Learning from patient deaths in CF: An audit of team debrief sessions at a UK adult CF centre

Abstract

Objectives End of life care in CF has become increasingly medicalised. Aggressive measures introduced to treat end stage respiratory disease as a bridge to transplant can lead to a tension between palliative & curative care. Challenges in delivering optimal end of life care in CF have been documented. Learning from patient deaths is crucial to develop CF care. Team “debriefs” have been identified as an important tool in both developing practice & providing psychological support following a patient's death, & are part of routine practice at MACFC. Analysis of such debriefs allows identification of important themes & areas for practice development for CF care at the end of life. Methods An audit was conducted to examine the 8 “team debriefs” (carried out following a patient death) over an 18 month period at MACFC. The summary notes from each debrief were analysed using thematic analysis (TA) by 4 independent coders from the CF team. TA allows recurrent ideas, themes & topics to be identified in a data set. Results Thematic analysis of debrief notes identified 9 broad themes that impacted on end of life care. These were: 1. symptom control/palliation issues 2. communication difficulties 3. family issues 4. team issues 5. patient issues 6. environmental issues 7. transplant issues 8. examples of good end of life care and 9. needs for further service development/team learning. Conclusion Audit of staff debrief sessions following patient deaths has proved valuable for informing future practice & service development in this area. Further work is planned to evaluate the staff support function of the current MACFC team debrief process following patient deaths.