Table 4 Evidence of an appropriate approach to care: examples
Approach Appropriate? | Frequency | Concept | Frequency | Illustrative quote |
|---|---|---|---|---|
Yes | 43 | However -.ACP/discussion around future goals would be useful | 18 | ‘Appropriate for management of CHF but clear that this is becoming more difficult with worsening renal function and decreased function and more frailty. ACP discussion and goals of care required.’ |
Appropriate Care | 21 | ‘Approach appropriate for management of sepsis. Code status appropriate given age and co-morbidities.’ | ||
New Diagnosis | 5 | ‘Appropriate management, given new diagnosis. Most of this admission has been focused on obtaining diagnosis, deciding on a management plan whilst managing symptoms.’ | ||
No | 19 | No Discussion | 14 | ‘No discussion with family regarding goals of care and the role of palliative care alongside treatment of chest infection. Admission only 24 hours if he does not respond to IV antibiotics, further family discussion is required.’ |
Approach to Management not Appropriate | 5 | ‘Appropriate management of sepsis on admission on the 09/05/11 but failed to improve and began to deteriorate from cardiac point of view with tachy-brady syndrome and sepsis. Code red called 26/05/11 when decision made not to escalate treatment. Family seem distressed by changes in the focus of care.’ |