Flow Coaching Academy talk Dying Matters with their End of Life Big Rooms
FCA Internal Communications Officer speaks to FCA coaches working in End of Life Care.
As part of Dying Matters week, our Internal Communications Officer Emma Perkins spoke to coaches from across the FCA network coaching End of Life Big Rooms. Below is an overview of some of the great work they have achieved.
University Hospitals Birmingham NHS Foundation Trust
Birmingham’s End of Life Big Room was set up in 2019 by co-coaches Dawn Chaplin, Deputy Director of End of Life and Bereavement and Joanne Wells, Clinical Project Support Manager. Research from Dying Matters shows that around 70% of people would like to die at home, but the reality is around 60% die in hospital. The team therefore wanted to improve their services and enable patients to have more choice surrounding the right place to die.
The role of the Big Room:
The Big Room facilitated a dedicated space where participants across the EOL pathway came together to share their goal and passion for enhancing patient care. They learned that team members often lacked a full understanding of how their role fit within the wider pathway and patient’s overall journey. These sessions were attended by 20-30 people spanning various roles including Community Nursing, Occupational Therapy, Hospices, Care Homes and more.
Every meeting started with a patient story to help frame conversations about what mattered most to patients, ensuring this was the heart of all improvement work.They also involved relatives with recent experience of the pathway, public and patient involvement groups and community groups, to give feedback and suggestions on improvement work to aid the pathway redesign.
What did they do?
Based at Solihull Hospital, the Big Room mapped the full pathway from initial referrals or admission into acute to discharge home, hospice, or care home. This mapping allowed each individual to see the whole pathway – where roles and responsibilities lay and identify potential barriers and new pathways that would enable patients to go home, if this was their/their family’s wish.
Following up on themes raised in the initial mapping session, a ‘Love and Nuts’ exercise used to help to steer the group into prioritising the themes and emerging work streams for future work. Another key area of research was the cultural influence into EOL care and how this may have an impact on various parts of the pathway. They worked with the Faith Advocacy group on the importance of communications that are inclusive and respectful.
Plans for the future
The team are now looking at establishing some in-reach projects where community teams will proactively work with acute teams to facilitate timely discharge to care facilities in the community. At the trust EOL is a key focus with further work taking please to increase hospital avoidance, where possible, and care for patients (and relatives) in the place of their choice.
Giving everyone in the pathway the chance to work together across traditional boundaries has really opened up the conversation and helped build bridges with teams and enhance effective communication.
Dawn Chaplin, Deputy Director End of Life and Bereavement
Hearing from patients and their relatives has really emphasised the importance of listening to individuals and respecting their wishes; the importance of doing everything we can to meet their individual needs – whether that’s at home or in hospital.
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield’s End of Life Big Room was started in January 2020 by co-coaches Ellie Smith, Consultant in Palliative Medicine and Clinical Lead for End of life care and Nick Deayton, FCA Business Manager. As EOL care is such a complex area that affects us all, the Big Room made it a priority to use FCA methodologies to approach the pathway more holistically. They aspired to look beyond what happens in Sheffield Teaching Hospitals and have innovated, adapted, and delivered some amazing work during the challenging circumstances of the past year.
The role of the Big Room
There is attendance from key people from across Sheffield with representation from Sheffield Carers’ Centre, Age UK, Community Nursing, Ambulance Trust, Acute Care, Social Care and Funeral Directors. The Big Room also benefits from partnership with Lab4Living, a research project hosted by Sheffield Hallam University that combines art and design with patient experience.
With regular attendance of 10-15 stakeholders from across the city, the Big Room naturally found a focus of supporting and involving carers of those approaching end of life. More recently they have been bringing carers’ stories to these meetings, alongside patient stories, and these have been powerful reminders to keep everyone connected to the aim.
What has the work included so far?
Working closely with IT to develop a programme that enabled patients to call relatives via iPads while visiting is restricted. This helped promote better patient wellbeing, aiding human interaction, reducing loneliness, and also helping reassure relatives/carers.
- Developing specific visiting guidance for the last days of life across the hospital during the pandemic when visiting has been so restricted.
- Adapting the bereavement support provided to families/carers.
- Establishing processes that encourage ward staff to make contact with carers routine. This is an opportunity to provide updates on their loved ones’ condition and also allows the carer to provide any information that will help ward staff improve individualised care.
- Supporting STH’s Single Point of Access (SPA) and District Nursing service to identify carers and offer them the support they need. Using SPA’s Social Prescribing service, additional support can be provided, including potential involvement of Sheffield Carers’ Centre.
Plans for the future
While much of their work has been Covid-19 focussed, many of it’s outcomes and procedures will continue to improve EOL care beyond the pandemic. Nick and Ellie have had some amazing feedback from those who have been involved so far and aim to continue implementing initiatives that improve end of life care for all.
Wider work
These are just two examples of some of the work taking place across our network in End of Life Care.
At Lancashire and South Cumbria Teaching Hospitals Andrew Fletcher, Medical Director at St Catherine’s Hospice & Consultant in Palliative Care and Sarah Cullen, Nursing, Midwifery & Allied Health Professionals Director recently started another End of Life Big Room. We’re really looking forward to seeing this patient-centred work progress and the improvements this will bring for those nearing end of life.
If you want to find our more about the Flow Coaching Academy and some of the improvement work we are doing, please get in touch with the team by sth.fca@nhs.net
For more information about Dying Matters Week please visit: https://www.dyingmatters.org/AwarenessWeek
