cillian twomey - hse/hfh joint oversight group
TRANSCRIPT
• Dying
• End of Life
• Death• whilst ….maximising living to the
fullest possible extent …..
• Bereavement
End-of-Life Care
No one should have to face death or bereavement without the appropriate care and support.
Optimum End-of-Life Care
is primarily about placing the individual at the centre of
ALL decision-making
Hospice Friendly Hospice Programme
• Joint IHF & HSE pilot in Our Lady of Lourdes Hospital, Drogheda
(2005-2006)
• HfH (IHF-HSE-AP) Programme
(2007-2012)
–Quality Standards• Patient – Family – Hospital – Staff
• Joint IHF & HSE pilot in Our Lady of Lourdes Hospital, Drogheda (2005-2006)
• HfH Programme (2007-2012)– Quality Standards
• Increasing enthusiasm, interest & involvement by healthcare staff – in all settings –– EoL Coordinators, – EoLC Committees, – Staff discussion and – protected time for education
47 Hospitals linked to the HfH Programme
Saolta RCSI
IE
S / SW
12/05/17 Presentation Title goes here 13
RCSI Hospitals Groups
Rotunda Hospital, Dublin
Beaumont Hospital
Connolly Hospital, Blanchardstown
Cavan General Hospital
Louth County Hospital, Dundalk
Our Lady of Lourdes Hospital, Drogheda
Saolta University Health Care Group
University Hospital Galway and Merlin Park
Letterkenny General Hospital
Sligo Regional Hospital
Mayo General Hospital
Roscommon County Hospital
Portiuncula Hospital, BallinasloeIreland East Hospitals Group
Mater Misericordiae University Hospital
National Maternity Hospital, Holles St
Midland Regional Hospital Mullingar
St Luke's General Hospital, Kilkenny
Wexford General Hospital
Our Lady's Hospital, Navan
St Vincent’s University Hospital (Public)
St Michael’s Hospital, Dun Laoghaire
South / South West Hospital Group
Cork University Hospital
Cork University Maternity Hospital
Bantry General Hospital
Mallow General Hospital
South Victoria University Hospital
Mercy University Hospital
South Tipperary General Hospital
Kerry General Hospital
University Hospital Waterford
Dublin Midlands Hospital Group
St James's Hospital
Tallaght Hospital
The Coombe Women and Infant University Hospital
Naas General Hospital
Midland Regional Hospital, Portlaoise
Tullamore Hospital
DM
University of Limerick Hospitals Group
University Hospital, Limerick
University Maternity Hospital, Limerick
Nenagh Hospital
Ennis Hospital
St John’s HospitalUL
(August 2016)
Children’s Hospitals
Our Lady's Children's Hospital, Crumlin
Templet St Children’s University Hospital
Private Hospitals
Mater Private Hospital
The Galway Clinic
Bons Secours Hospital, Dublin
The Beacon Hospital, Dublin
The Hermitage Medical Clinic
S-SW
Irl-East
SaoltaRCSI
A Good Death (2014)
A Reflection on Ombudsman Complaints about End of Life Care in Irish Hospitals
Oifig an OmbudsmanOffice of the Ombudsman
Website: www.ombudsman.ie
Survey of Bereaved Relatives
VOICES MaJam Results (2016) Mater Misericordiae University Hospital, Eccles Street, Dublin 7
www.mater.ie
St James’s Hospital, James’s Street, Dublin 8
www.stjames.ie
Voices – MaJam Survey of Bereaved Relatives
•356 Relatives – 2 Hospitals – 46% Response Rate
•Quality of Care
• Outstanding – 34%
• Excellent – 36%
• Good – 17%
• Fair– 7%
• Poor– 5%
• Don’t Know– 1%
10 years on …….• Increased awareness of palliative and end of life
issues
• Service improvement focus and pivot for change
• Facilitates practical expression of HSE corporate and staff values
• Design and Dignity Grant system provides funding for build environment
• Maternity and Child Networks highlight needs of particular groups
Joint HSE-HfH Oversight Group
• Provide recommendations on approach to mainstreaming the HfH programme across hospitals into the future.
• Provide practical recommendations on increasing the level of awareness and communications associated with HfH across hospitals nationally
• Provide recommendations on alignment of HfH within the broader Acute Hospital Division – quality and service improvement initiatives (e.g. National and Hospital Group Strategic / Operational plans).
Joint HSE-HfH Oversight Group
• Provide recommendations on alignment of HfH within other HSE division quality and service improvement initiatives (e.g. Quality Improvement, HR, Primary Care).
• Assess the expansion opportunities for the HfH programme across the hospital system
• With the agreement of the Hospital Group CEOs, the Oversight Group may facilitate joint and collaborative working across hospitals on specific initiatives or projects.
Membership
• Chairman• Clinical Programme representatives from Emergency
Department, Older Persons, Paediatric Care and Palliative Care,
• End-of-Life Coordinator reps x 2• HfH Acute Network Chair• HSE (Acute Hospital Division) • HSE (Primary & Community Care) – 2018 • HSE (Quality Improvement)• Hospital Group CEOs • Hospital Group DoNs • IHF reps x 2• Office of the Ombudsman
So far …..
• Inaugural OG meeting – 8 May 2017– 2 Oct 2017– Next meeting 19 Feb 2018
• Met Ombudsman (20 Oct ‘17)
• Planning to meet Hospital Groups CEOs
Themes to datePatient Experience: •How can HfH programme be informed by experience of patients and families?
Linkages with Clinical Leads: •How can HfH cross reference existing outputs with HSE Clinical Programmes
Education/Training: •Identify approach to review FJ training and determine other ways to improve content and access to education and training on end of life, palliative and bereavement care
Care delivered at End-of-Life?•How can the oversight programme reduce variability that exposes care delivered at end of life?
Working Relationships
National Director Acute Hospitals
ChairOversight Group
Joint Oversight
Group
Hospital Groups CEOs
Hospitals and EoL Committees
HSE (Primary & Community Care)
Ireland – 65yrs+
• by 2020 – 1 in 4 will be >65 years
• by 2050 - older people will outnumber children for the first time
Ageing demography
• Life Expectancy –
– 83.5 yrs (female)
– 79.3 yrs (male)
• Census 2016 – 637,567– an 19.1% increase since Census 2011
– projected to > by 167% by 2048
It is essential that:
–ALLHSE CEOs, DoNs & Clinicians/Clinical Leads buy-in and support
• include HfH funding in their Annual Service Plans