Gold standards framework implementation in an acute hospital: end-of-life outcomes.

Area of Science:

• Palliative Care
• Healthcare Management

Background:

• Hospitals are the most common place of death in the UK, with 30% of patients dying during their last year of life.
• National policies advocate for early identification and proactive planning to support patients' preferred place of death.
• The Dudley Group NHS Foundation Trust implemented the Gold Standards Framework (GSF) to identify patients nearing end-of-life and guide care.

Purpose of the Study:

• To evaluate the impact of Gold Standards Framework (GSF) coding on advance care planning (ACP) and place of death outcomes.
• To assess if GSF implementation influences patient care alignment with preferences.

Main Methods:

• Retrospective review of adult inpatients at a UK hospital who died within 12 months of 01/09/2023.
• Patients categorized as GSF-coded or non-coded.
• Assessed outcomes included documented ACP and place of death.

Main Results:

• Of 216 deceased patients, 104 (48%) were GSF-coded.
• GSF-coded patients (Green/Amber) showed higher ACP documentation (54% vs. 13%) compared to non-coded patients.
• GSF-coded patients were more likely to die outside the hospital (65% vs. 45%), a trend consistent across cancer and non-cancer diagnoses.

Conclusions:

• GSF implementation and coding facilitate earlier end-of-life identification.
• GSF coding is associated with increased advance care planning engagement.
• GSF coding correlates with a reduction in hospital deaths, promoting patient-preferred end-of-life care and potential cost savings.