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Table 1 Overview of the nine components within the implementation guide

From: Implementing the care programme for the last days of life in an acute geriatric hospital ward: a phase 2 mixed method study

Number Content
Component 1 Establishing the implementation project and preparing the environment
▪ Informing the geriatric health care staff about the implementation project and the importance of change in care during the last days of life
▪ Executive endorsement: acquiring management approval for the trainings and audits
▪ Involvement of specialist palliative care services is recommended: at least one member of the Palliative Support Team of the hospital is member of the steering group
▪ Facilitators: a nurse and a physician of the geriatric ward
▪ Formation of steering group: at least four people from the geriatric ward (facilitators included)
▪ Intensive 2-day training of facilitators
Component 2 Preparing the documentation
▪ Development of an information leaflet for family carers about the facilities in the geriatric hospital ward
Component 3 Baseline review
▪ Analyzing end-of-life care data of deceased geriatric hospital patients using the patients’ medical files
Component 4 Training geriatric health care staff
▪ Feedback of the results to the staff and focusing on improvement within the geriatric ward
▪ Facilitators and specialist palliative care colleagues train geriatric health care staff with the aid of a training package (i.e. hand-outs with information about the Care Guide for the Last Days of Life, a copy of the Care Guide for the Last Days of Life, a casus to discuss in group etc.)
Component 5 Care Guide use and intensive support
▪ Care Guide use after sufficient training and education
▪ Intensive support and supervision by the steering group through repeated coaching, telephone and direct guidance, discussion of clinical cases and clinical audits
Component 6 Semi-intensive support
▪ Semi-intensive support and supervision by the steering group through repeated coaching, telephone and direct guidance, discussion of clinical cases and clinical audits
Component 7 Evaluation
▪ To organize a qualitative evaluation of the implementation: evaluating and discussing the performance and progress of each of the previous components
▪ The qualitative evaluation acknowledges areas where further support, education or training is needed
Component 8 Consolidation
▪ To adopt a strategy to maintain/improve the implementation and sustainability of the Care Guide
▪ Support and supervision by the steering group through repeated coaching, telephone and direct guidance, discussion of clinical cases and clinical audits
Component 9 Ongoing education, training and support
▪ Keeping up to date with developments in end-of-life care and a continuing education and evaluation within the hospital ward
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