Table 1 Classification of innovations which may avoid inappropriate or non-beneficial hospital admission and/or reduce bed days for patients at end of life: definitions and sources of information

1

Facilitating entry into the hospice and community care system

Single point of access

Access to a range of medical, nursing and social care services for patients, carers and healthcare professionals via a single telephone number.

[27]

2

Preventing hospital admission

2a; Care home innovations

A mixed group, including training programmes for nursing home staff.

[28,29,30,31,32,33,34,35,36,37]

2b; Palliative care support in the community, 24/7 hospice at home service

Coordinated palliative care delivered in the patient’s home through regular visits by specialist medical and nursing staff, often in association with a hospice.

[38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55]

2c; 24/7 helpline

Support for patients, carers, paramedics and non-specialist doctors and nurses.

[27, 39, 46, 48, 56]

2d; Telehealth/

telecaring

Provision of healthcare remotely using telecommunication technology.

[36, 37, 39, 57, 58]

2e; Ambulance staff education

Training for better communication and decision-making when attending patients at the end of life.

[59]

2f; Integrated palliative care

Coordinated input from different healthcare professionals and caregivers.

[60,61,62,63,64,65,66,67,68,69,70,71,72,73]

2 g; Palliative care outreach in rural areas

Palliative consultant attends the patient in their own home and coordinates care.

[56, 74]

3

Facilitate discharge

3a; Hospital or emergency department-based discharge service

Patients requesting or considered suitable for discharge into supported care (community, nursing home, hospice) are identified by a hospital-based doctor or nurse who facilitates onward management.

[56, 66, 72, 75,76,77]

3b; Nurse-led palliative care inpatient capacity expansion

Offering additional nurse-led beds for less complex patients.

[78]