Survey of Foundation Year 1 doctors caring for the dying; what do they see, do and need to perform this role, following removal of the Liverpool Care Pathway?

Murray-Brown, Fay; Curtis, Matt; Gibbins, Jane

doi:10.1177/0269216315601951

Cited by 8 publications

(11 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While this could be perceived as positive and in keeping with NICE guidelines about individualised prescribing, a regional survey of first year doctors reported one of their main needs was for formal guidance with symptom control. These doctors reported difficulties with remembering doses of anticipatory medication [ 13 ]. Importantly, the 2015 National audit also highlighted variability in the results between individual hospitals and the continued limited availability of 24/7 palliative care services [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Quality assurance for care of the dying: engaging with clinical services to facilitate a regional cross-sectional survey of bereaved relatives’ views

Mayland

McGlinchey

Gambles

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundGlobally, having the ‘patient and /or family voice’ engaged when measuring quality of care for the dying is fundamentally important. This is particularly pertinent within the United Kingdom, where changes to national guidance about care provided to dying patients has heightened the importance of quality assurance and user-feedback. Our main aim was to engage with clinical services (hospice, hospital and community settings) within a specific English region and conduct a bereaved relatives’ cross-sectional survey about quality of care. Our secondary aim was to explore levers and barriers to project participation as perceived by organisational representatives.MethodsEach organisation identified a consecutive sample of next-of-kin to adult patients who died between 1st September and 30th November 2014. Those who had an unexpected death or were involved in a formal complaint were excluded. The ‘Care Of the Dying Evaluation’ (CODE™) questionnaire was posted out three months following the bereavement. One-to-one interviews were undertaken with a purposive sample of organisational representatives to explore experiences about project participation.ResultsOf the 30 invited organisations, 18 were able to participate comprising: 7 hospitals, 7 hospices and 4 community settings. There were 1774 deaths which met the inclusion criteria but 460 (26%) were excluded due to inaccurate next-of-kin details. Subsequently, 1283 CODE™ questionnaires were sent out, with 354 completed (27% response rate). Overall, most participants perceived good quality of care. A notable minority reported poor care for symptom control and communication especially within the hospital. Nine interviews were conducted - levers to project participation included the ‘significance of user-feedback and the opportunity to use results in a meaningful way’; the main barrier was related to ‘concern about causing distress to bereaved relatives’.ConclusionsOverall, being able to engage with 18 (60%) organisations within the region and conduct the bereaved relatives’ survey showed success of this initiative and was supported by interview findings. The potential to be able to benchmark user-feedback against other organisations was thought to help focus on areas to develop services. This type of quality assurance project could form a template model and be replicated on a national and international level.

show abstract

Section: Introductionmentioning

confidence: 99%

Quality assurance for care of the dying: engaging with clinical services to facilitate a regional cross-sectional survey of bereaved relatives’ views

Mayland

McGlinchey

Gambles

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…This study is the first of hospice-based F1s and demonstrates that such placements can enable F1s to gain confidence in end-of-life care and communication -areas that newly qualified doctors may Hospice placements for foundation year doctors find challenging. 6,7,8 As other studies in similar settings have found, participants valued experiential, informal learning opportunities, particularly when interacting with patients and other staff. 9,10,16,17 Here, this experiential learning was achieved with suitable support from staff, but in other studies learning on the job has been described by junior doctors as being through making mistakes and being 'thrown in at the deep end'.…”

Section: Discussionmentioning

confidence: 79%

“…5 Newly qualified doctors can feel unprepared, unsupported and even distressed when caring for dying patients. 6,7,8 They have described 'being left' to cope, fearful that their lack of experience could make things worse for patients. 9 Palliative care is often learnt on the job, with little formal teaching.…”

Section: Introductionmentioning

confidence: 99%

Education and Training: Perceived educational impact, challenges and opportunities of hospice placements for foundation year doctors: a qualitative study

Frearson

2019

Future Healthcare Journal

View full text Add to dashboard Cite

Foundation year one doctors (F1s) are expected to recognise and care for dying patients, but previous studies have found they can feel unprepared, stressed and unsupported when faced with such situations. Although hospice placements can provide good experiential learning for junior doctors, no studies to date have included F1s. This study used an interpretivist approach to explore educational opportunities and challenges in hospice placements from an F1's perspective. Six F1s who had recently completed hospice placements were interviewed individually. Data analysed qualitatively showed that F1s valued informal experiential learning and felt well supported by senior doctors. The most important learning outcome was the acquisition of enhanced communication skills and challenges included the risk of becoming medically deskilled. F1s felt their medical practice had changed as a result of hospice placement, most commonly in communication skills and recognition of the dying phase. The author recommends increased utilisation of hospice placements in foundation training programmes.

show abstract

“…Recent research demonstrated that only 55% of junior doctors surveyed 'always' prescribe anticipatory medicines, and many who still had access to the LCP still relied on it unofficially for guidance on caring for dying patients. 13 In the light of these findings, could the apparent recent fall in rates of anticipatory prescribing for certain symptoms (above) be an early warning sign of the gap left by the LCP?…”

Section: 'Tick-box' Care: Friend or Foe?mentioning

confidence: 99%

In defence of the ‘tick-box approach’: why end-of-life care is no exception

Knights

2016

Br J Gen Pract

View full text Add to dashboard Cite

Survey of Foundation Year 1 doctors caring for the dying; what do they see, do and need to perform this role, following removal of the Liverpool Care Pathway?

Cited by 8 publications

References 2 publications

Quality assurance for care of the dying: engaging with clinical services to facilitate a regional cross-sectional survey of bereaved relatives’ views

Quality assurance for care of the dying: engaging with clinical services to facilitate a regional cross-sectional survey of bereaved relatives’ views

Education and Training: Perceived educational impact, challenges and opportunities of hospice placements for foundation year doctors: a qualitative study

In defence of the ‘tick-box approach’: why end-of-life care is no exception

Contact Info

Product

Resources

About

Survey of Foundation Year 1 doctors caring for the dying; what do they see, do and need to perform this role, following removal of the Liverpool Care Pathway?

Cited by 8 publications

References 2 publications

Quality assurance for care of the dying: engaging with clinical services to facilitate a regional cross-sectional survey of bereaved relatives’ views

Quality assurance for care of the dying: engaging with clinical services to facilitate a regional cross-sectional survey of bereaved relatives’ views

Education and Training: Perceived educational impact, ­challenges and opportunities of hospice placements for foundation year doctors: a qualitative study

In defence of the ‘tick-box approach’: why end-of-life care is no exception

Contact Info

Product

Resources

About

Education and Training: Perceived educational impact, challenges and opportunities of hospice placements for foundation year doctors: a qualitative study