End of life care in the acute hospital setting

  title={End of life care in the acute hospital setting},
  author={Polly M. Edmonds and Rachel Burman and Wendy Prentice},
  journal={BMJ : British Medical Journal},
An update of the Liverpool care pathway does much to tackle recent criticisms 
Managing sudden death in hospital
Junior doctors play an important role in verifying sudden deaths in hospital and communicating with the family of the deceased. This article covers England and Wales; the situation in Scotland and
Improvements in end-of-life care with a protocol-based pathway for cancer patients dying in a Singapore hospital.
This study shows promising results for improving end-of-life care in cancer patients with a protocol-based pathway in a Singapore hospital and extension of this care pathway to other settings should be explored.
An evaluation of routine specialist palliative care for patients on the Liverpool Care Pathway.
The authors' model of care could overcome many of the issues relating to the LCP and would ameliorate the developing vacuum of care for patients at the end of life.
End-of-life care in the general wards of a Singaporean hospital: an Asian perspective.
There was a lack of commitment by doctors on orders for DNR/CPR and to limit life-sustaining therapies, infrequent discussions with patients on end-of-life decisions, and excessive burdensome interventions with inadequate palliative care for the dying.
The Liverpool Care Pathway for the Dying Patient: a critical analysis of its rise, demise and legacy in England
An in-depth account of LCP development and implementation with explanatory theoretical perspectives calls for greater assessment of the wider risks and more careful consideration of the unintended consequences that might result from the roll out of new end-of-life interventions.
The Liverpool Care Pathway for the Dying Patient: a critical analysis of its rise, demise and legacy in England.
It exposed fault lines in the NHS, provided a platform for debates about the 'evidence' required to underpin innovations in palliative care and became a conduit of discord about 'good' or 'bad' practice in care of the dying.
End-of-life-care for Chinese patients in acute care ward setting: Experience in an oncology ward and report on a pilot project on the use of an integrated care pathway
An integrated pathway modified from the Liverpool Care Pathway for the Dying Patient and end-of-lifecare pathway used in a Palliative Care Unit in Hong Kong Special Administrative Region, China has been designed for use in the department’s ward to improve the organization of end- of-life care.
Exploring the extent of Communication Surrounding Transitions to Palliative Care in Heart Failure: The perspectives of Health Care Professionals
There is a need for both established prognostic guidelines and further education to develop the communication skills to facilitate end-of-life discussions with HF patients.
Navigating tensions: integrating palliative care consultation services into an academic medical center setting.
An in-depth understanding of the dynamic interaction of the infrastructures and processes of a successful institutionalization, in their unique complexity, may help other PCCSs identify and negotiate attributes of their own circumstances that will increase their chances for successful and sustainable implementation.
Dying in the hospital: what happens and what matters, according to bereaved relatives.
QOD appears to be a multidimensional construct, strongly affected by medical care and staff attentiveness, explaining 34% of the variation of QOD scores.


Care of the dying patient: the last hours or days of life.
Evidence based guidelines on symptom control, psychological support, and bereavement are available to facilitate a “good death”
The effect of the Liverpool Care Pathway for the dying: a multi-centre study
In the Intervention period, the documentation of care was significantly more comprehensive compared with the baseline period, whereas the average total symptom burden was significantly lower in the intervention period.
Care of the dying: setting standards for symptom control in the last 48 hours of life.
The aim of this study was to implement an ICP in an inpatient hospice setting in order to set standards of care for symptom control in the dying phase of a patient's life, and there was a statistically significant increase in the number of patients whose pain was controlled.
'All the services were excellent. It is when the human element comes in that things go wrong': dissatisfaction with hospital care in the last year of life.
The study findings suggest that adoption of the palliative care approach could reduce the experience of dissatisfaction for many service users, not only those whose deaths are anticipated.
Marie Curie Palliative Care Institute. National care of the dying audit of hospitals-round 2 results
  • 2009
Marie Curie Palliative Care Institute. Liverpool care pathway
Royal College of Physicians. National Care of the Dying Audit of Hospitals