Evaluation of the impact of three Pilot training schemes on end of life care in nursing homes

Background:

A 2008 a literature review undertaken by the University of Warwick and the University of West of England underlined the lack of research and resources in quality-of-life End of Life Care (EoLC).

What was the problem?

East of England Strategic Health Authority and Primary Care Trusts decided to invest in training to improve the attitude, knowledge and skills of nursing home staff and GPs so that elderly people are treated more appropriately as they approach the end of their lives and not automatically sent to hospital.

How did PHAST help?

PHAST was commissioned to evaluate the impact of three Pilot training schemes on end of life care in nursing homes.

Two of the schemes were put in place by GSF (Gold Standard Framework), one over 12 months and the other 9 months. The third programme, named ABC Programme, was specifically designed for East of England and which continued over 12 months.

The results show that GSF and ABC programmes had no significant difference in staff satisfaction, increase in staff confidence and competence or next-of-kin satisfaction.

However the flexibility of the ABC Programme permitted a higher number of staff to complete the training. It also offered better support to the trainers and was therefore found to be more cost effective than the GSF programme.

What was the Impact?

These results have led to recommendations to commissioners on how and when to undertake staff training in End of Life Care. PHAST also noticed a modest reduction in death rates in hospital, unscheduled admissions and bed days.