The Irish Hospice Foundation (IHF) has released Draft Quality Standards For End-of-Life Care In Hospitals for public consultation as part of its ongoing effort to ensure high-quality care for all patients at end of life in hospitals particularly within the acute care setting.

Some 30,000 people die in Ireland each year. While most people wish to die at home, the reality is that three quarters of all deaths take place in hospitals and long-stay facilities – 40% of people in acute hospitals.
Draft Quality Standards for End of Life in Hospitals is the second part of the standards development project of the IHF’s Hospice Friendly Hospitals (HFH) Programme. The HFH Programme itself is a five-year flagship programme of the IHF which is currently operating in over 40 acute and community hospitals nationwide. The aim of the programme is to put hospice principles into hospital practices.

The Draft Quality Standards for End of Life Care were developed in partnership with a range of organisations including a number of the hospitals in Dublin: the Mater Misericordiae University Hospital; Connolly Hospital, Blanchardstown; the Royal Hospital, Donnybrook and Our Lady’s Hospital for Sick Children, Crumlin.

The consultation process on the latest standards will end on Friday, 31st July and the final standards are due to be published in September 2009.
Draft Quality Standards for End-of-life Care in Hospitals identify the essential elements that need to be in place to ensure a consistent quality approach to end-of-life care across the hospitals setting – whether a death is sudden or expected.

The four standards are:
1. Patient care
2. Support for families
3. Staff Training and Support
4. An Integrated Hospital Approach

Each standard has an explanation of the reasons this standard is necessary and the criteria for each standard will allow hospitals to assess if they have met the standard. The standards set out what a person at end of life and his/her family can reasonably expect from hospitals in terms of service provision, support and quality care. They also outline how training and supports for hospital staff should be delivered in order to enhance end-of-life care. They show how hospitals systems should function to ensure that the best possible care is delivered in a coordinated way to patients at end of life. Helen Donovan, Standards Development Coordinator of the HfH Programme, stated:
“End-of-life care is often not seen as a core activity of hospitals despite the fact that most people die there. End-of-life care is normally not included in service plans or adequately reflected in hospital cultures, systems and structures. While there are many instances where people receive high quality end-of-life care in our hospitals, the challenge is to ensure that every patient can die in comfort and dignity in our hospitals.” Hospitals have to deal with death and dying in many scenarios: miscarriage; stillbirth; the death of a baby, child or teenager; traumatic death such as murder, suicide; sudden death as in a car accident and diagnosis of life-limiting disease. She continued: “End-of-life care is complex. Hospitals must take into account not only people’s needs but their expressed preferences, their cultural values, religious beliefs, spiritual and sexual orientation. It involves complex questions and issues – advance care planning, preferred place of care, organ donation, wills and power of attorney. These draft standards have at their core the need for greater engagement by hospitals around issues of end-of-life care. They identify the essential elements that need to be in place to ensure a consistent quality approach to end-of-life care across the hospitals setting.” Mervyn Taylor, HfH Programme Manager, commented: “The publication of these Draft Standards is an important early milestone in the development of Hospice Friendly Hospitals. Implementing these standards will require a cultural shift in some of our hospitals and we are committed to supporting the development of the capacity of hospitals to not only meet but, where possible, exceed these standards. While the primary focus in acute hospitals is and will remain on curing people, hospitals must embrace the reality of dying and death and take a proactive and coordinated approach to meeting the needs of patients who need end-of-life care and of their families.”

The Health Information and Quality Authority (HIQA) is the state agency with responsibility for setting standards in health and social services and monitoring healthcare quality. HIQA has endorsed the work of the HFH Programme in the development of standards for end-oflife care in hospitals. The HfH programme envisages that its standards will be referenced within the National Standards for Quality and Safety and will inform future reviews carried out by HIQA.

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For more information, please contact:
Caroline Lynch,
Communications/Advocacy Manager,
The Irish Hospice Foundation
01-679 31 88 or 087-123 75 86.
Note to Editor
Draft Quality Standards for End-of-life Care in Hospitals and consultation feedback form are available to download or complete online at www.hospicefriendlyhospitals.net. Hard copies are also available on request from the IHF at 01-679 31 88. The closing date for submissions is Friday, 31st July. The standards will be published in September 2009.