Implementing Hospice at Home Out-of-Hours Palliative Care

PALLIATIVE CARE

Implementation of Hospice at Home Out-of-Hours Service

Improving access to palliative care

Enhancing patient outcomes and system efficiency

BACKGROUND

Identifying the Need

Recognised gap in out-of-hours palliative care provision

Limited support for patients and families during evenings and weekends

Increased reliance on emergency services

Frequent hospital admissions that could be avoided

IMPLEMENTATION

Steps for Implementing the New Service

Clear vision and objectives

Everyone aligned on purpose and goals

Clear lines of communication

Top down and bottom up

Training and education

Equipping staff with the right skills

Pilot of the service

Testing before full rollout

Feedback from staff and key stakeholders

Continuous listening

PHASE 1

Pilot Programme

SERVICE DETAILS

Monday to Friday, 2:00 PM – 10:00 PM

1 nurse covering

KEY FOCUS

Provide responsive, community-based palliative care support

Urgent symptom management and patient support at home

CHALLENGES & SOLUTIONS

Lone worker devices implemented to ensure staff safety after hours

Clinical supply backpacks provided to all nurses

RATIONALE FOR CHANGE

Why This Service Was Needed

High number of ambulance call-outs out of hours

Avoidable hospital admissions

Patients wishing to remain at home at end of life

Limited support for rapid discharge from hospital

OUTCOMES

Early Impact

Significant reduction in ambulance call-outs

Decrease in hospital admissions

Improved patient and family experience

Enhanced ability to support patients in their preferred place of care

PHASE 2

Extended Provision

Phase 1

Mon–Fri only

2:00 PM – 10:00 PM

1 nurse

Phase 2

Monday to Sunday (7-day coverage)

Evening nurse: Mon–Sun

Daytime nurse: Saturday & Sunday

8:00 AM – 4:30 PM

Increased accessibility and continuity of care

WIDER BENEFITS

System and Team Impact

Hospital Transitions

Supported rapid discharges from hospital

Relieving Strain

Reduced pressure on acute services

Coordinated Care

Improved coordination across care teams

Extended Support

Daytime palliative care nurses supported by out-of-hours service

FEEDBACK

Collaborative Approach

FEEDBACK GATHERED FROM:

Clinical teams

Partner organisations

Stakeholders

KEY OUTCOMES:

Positive responses highlighting improved service delivery

Strong interdisciplinary collaboration

EVALUATION

Monitoring and Review

Service carefully planned and implemented

Continuous evaluation throughout the process

Adjustments made based on feedback and outcomes

Commitment to responsive, patient-centred care

Plan

Implement

Evaluate

Adjust

SUCCESS FACTORS

Why It Was Successful

Clear Vision

Everyone understood why the change was happening — from senior management to staff delivering care

Early Staff Engagement

Staff were involved in the change process from the beginning

Transparent Communication

Frequent, open communication and service adjustments based on team feedback

Electronic Prescribing

Facilitated real-time medication changes with ease and efficiency

CONCLUSION

Key Takeaways

Addressed a critical gap in palliative care

Reduced unnecessary hospital use

Improved patient outcomes and experiences

Created a more sustainable and supportive care model

Compassionate care, closer to home.