Table 1.

Themes of care identified for different phases of a hospital stay

AdmissionOngoing careEnd-of-life careOverall care
DiagnosisOngoing senior inputDying recognised and documentedTimely, safe, high-quality care
Assessment and severityComplications recognised and managed
Monitored appropriately and acted upon
End-of-life prescribingAppropriate place of care
BackgroundPlan followed/adjusted as neededDNACPR and treatment escalation planViews of patient and/or family considered
Assessment of frailtyDeterioration recognisedIndividualised care plan for dying patientInvolvement of parent teams, specialists, high-acuity teams (eg intensive care)
InvestigationsPlan with appropriate escalationMonitoringClear and senior-led decision-making processes
Escalation planningPatient and next-of-kin involvementEvidence of consideration of patient wishesOut-of-hours care
Referrals, specialist inputSpecialty involvementCommunication with patient and/or familyAppropriate handovers
Patient and family/next-of-kin inputTransfers of careInvolvement of palliative care team for those with complex needs
Management planSystem issues identified
Senior reviewMedical Emergency Team call/cardiac arrest call?
  • DNACPR = do not attempt cardiopulmonary resuscitation.