PPT26 Evaluating the impact of the GREAT discharge tool on end-of-life medication communication from an acute hospital
Year: 2026
Type: conference-abstract
Abstract: Background The Dudley Group NHS Foundation Trust (DGFT) has introduced the GREAT discharge tool to support with discharge communication for patients at the end-of-life. Embedded in electronic patient records, it supports sharing of GSF codes, Resuscitation Status, End-of-Life Care medications, Advance Care Plans, and Treatment Escalation Plans. To evaluate the impact of the tool on discharges, a retrospective review of all patients discharged with end-of-life care subcutaneous (sc) anticipatory medications was conducted, to review the quality of the communication and their appropriateness. Method With informatics support, all patients discharged between 01/01/25 and 28/02/25 with end-of-life care sc anticipatory medication were reviewed. Discharge letters were examined for inclusion of GSF code, resuscitation status, and end-of-life medication details. Prescriptions were assessed for appropriateness and individualisation. Time from discharge to recorded death was evaluated to retrospectively determine appropriateness of discharge with end-of-life care sc medications. Results There were 100 patients discharged with end-of-life medications. 96% of patients were discharged with a recorded GSF code (with 95% recorded as GSF Amber or Red). 97% of patients had individualised prescriptions of end-of-life sc anticipatory medications, and all patients had a documented resuscitation status. At the time of review, 89% of patients had died. For patients with a GSF Red code, the average time from discharge to death was 6 days (median 3.5 days). For patients with a GSF Amber code the average time from discharge to death was 17 days (median 8 days). Conclusion The GREAT discharge tool has markedly improved communication and documentation of end-of-life care at discharge. High inclusion rates of GSF codes, resuscitation status, and personalised prescriptions indicate enhanced clarity and patient-centred care planning. The timing from discharge-to-death suggests generally appropriate discharges with tailored end-of-life support matching prognosis. Ongoing use and refinement are recommended to maintain and enhance discharge processes for patients nearing end of life.
Source: BMJ Supportive & Palliative Care
Institution: Dudley Group NHS Foundation Trust
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7140729720