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An evaluation of the implementation of a programme to improve end-of-life care in nursing homes

School of Health and Population Sciences, University of Birmingham, Birmingham f.j.badger{at}bham.ac.uk

C Clifford

School of Health and Population Sciences, University of Birmingham, Birmingham

A Hewison

School of Health and Population Sciences, University of Birmingham, Birmingham

K Thomas

Gold Standards Framework National Centre, Walsall Teaching PCT, Walsall; School of Health Population, University of Birmingham, Birmingham; Omega, the National Association for End of Life Care, London House, Town Walls, Shrewsbury, Shropshire

The Gold Standards Framework in Care Homes programme aims to improve the quality of end-of-life care for residents. The impact of introducing phase 2 of the programme to homes in England was evaluated. A pre–post survey design was adopted, focusing on indicators identified as markers of good end-of-life care. The 95 homes in phase 2 of the programme were invited to participate in the evaluation. Homes completed a baseline survey of care provision and an audit of the five most recent resident deaths. The survey and audit were repeated post programme completion. Forty-nine homes returned completed pre- and post-surveys, 44 returned pre- and post-data on deaths. Although some staff found completion of the programme challenging, homes that returned pre- and post-data demonstrated improvements in aspects of end-of-life care. There were statistically significant increases in the proportion of residents who died in the care homes and those who had an advanced care plan. Crisis admissions to hospital were significantly reduced. This evaluation indicates that appropriately funded structured programmes have the potential to assist nursing homes improve the provision of end-of-life care to older adults, in line with government health policy.

Key Words: end-of-life care • nursing homes • older people • survey

This version was published on September 1, 2009

Palliative Medicine, Vol. 23, No. 6, 502-511 (2009)
DOI: 10.1177/0269216309105893


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