Table 1 Overview of the nine components within the implementation guide
N° | Content |
|---|---|
Component 1 | Establishing the implementation project and preparing the environment |
| Â | â–ª Informing the geriatric health care staff about the implementation project and the importance of change in care during the last days of life |
| Â | â–ª Executive endorsement: acquiring management approval for the trainings and audits |
â–ª Involvement of specialist palliative care services is recommended: at least one member of the Palliative Support Team of the hospital is member of the steering group | |
| Â | â–ª Facilitators: a nurse and a physician of the geriatric ward |
| Â | â–ª Formation of steering group: at least four people from the geriatric ward (facilitators included) |
| Â | â–ª Intensive 2-day training of facilitators |
Component 2 | Preparing the documentation |
| Â | â–ª Development of an information leaflet for family carers about the facilities in the geriatric hospital ward |
Component 3 | Baseline review |
|  | ▪ Analyzing end-of-life care data of deceased geriatric hospital patients using the patients’ medical files |
Component 4 | Training geriatric health care staff |
| Â | â–ª Feedback of the results to the staff and focusing on improvement within the geriatric ward |
| Â | â–ª Facilitators and specialist palliative care colleagues train geriatric health care staff with the aid of a training package (i.e. hand-outs with information about the Care Guide for the Last Days of Life, a copy of the Care Guide for the Last Days of Life, a casus to discuss in group etc.) |
Component 5 | Care Guide use and intensive support |
| Â | â–ª Care Guide use after sufficient training and education |
| Â | â–ª Intensive support and supervision by the steering group through repeated coaching, telephone and direct guidance, discussion of clinical cases and clinical audits |
Component 6 | Semi-intensive support |
| Â | â–ª Semi-intensive support and supervision by the steering group through repeated coaching, telephone and direct guidance, discussion of clinical cases and clinical audits |
Component 7 | Evaluation |
| Â | â–ª To organize a qualitative evaluation of the implementation: evaluating and discussing the performance and progress of each of the previous components |
| Â | â–ª The qualitative evaluation acknowledges areas where further support, education or training is needed |
Component 8 | Consolidation |
| Â | â–ª To adopt a strategy to maintain/improve the implementation and sustainability of the Care Guide |
| Â | â–ª Support and supervision by the steering group through repeated coaching, telephone and direct guidance, discussion of clinical cases and clinical audits |
Component 9 | Ongoing education, training and support |
| Â | â–ª Keeping up to date with developments in end-of-life care and a continuing education and evaluation within the hospital ward |