1. WMQRS Good Practice Event Implementing Amber Care Bundle
to improve End of life care.

4. Liverpool Care Pathway – Best practice Tool used on all adult wards for patients in the last days of life where there is deemed no reversible cause for their deterioration.
The use of the AMBER Care Bundle complies with the NICE Quality Standard QS013 - End of life care for adults & Peer Review Self-Assessment for clinical teams i.e. COPD/Cardiology

6. What does it do? Gap between health and dying with uncertain outcome
Ability to recover or deteriorate
Communication issues
DNACPR
Ceiling of Care
Communication
Situation
Plan
Choices – PPC/PPD
Advance Decisions

7. Benefits include –
improved decision making
positive impact on multi-professional team communication & working
increase in nurses’ confidence about approaching medical colleagues to discuss treatment plans
patients are treated with greater dignity & respect
greater clarity around patient preferences & how they can be achieved
reduction in unnecessary interventions & readmissions

8. Why implement AMBER on a Respiratory Ward ?
Reduce the number of patient deaths on the ward
To improve the gap in the quality of care for those on the LCP
Support active treatment alongside an end of life care plan and symptom manage.
FOR MANY COPD PATIENTS RECOVERY IS UNCERTAIN AND READMISSION RATES ARE HIGH, WE SHOULD BE ASKING:
Is the patient deteriorating, clinically unstable and with limited reversibility?
Is the patient at risk of dying in the next 1-2 months?

9. Facts :
People with respiratory conditions are the most likely to die in hospital and the least likely to die at home.
 14 % of all deaths in England are attributed to respiratory disease rising to 20% if lung cancer is included.
69% of people with respiratory conditions (other than lung cancer) die in hospital – higher than any other condition
10% of deaths involving pneumonia or acute respiratory infection die at home

10. Acute/community interface
Rapid Discharge Pathway
Produced an Electronic Discharge Summary page
Out of Hours Form
Community Prescribing – PRN drugs EOL
Talk at Local/National Conferences etc.

11. Contact Details for further information
End of life Care Facilitators at Worcestershire Acute Hospital Trust
&