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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

From: A scoping review of initiatives to reduce inappropriate or non-beneficial hospital admissions and bed days in people nearing the end of their life: much innovation, but limited supporting evidence

Classification of innovation Types of innovation and examples of what is involved Publications providing quantitative data included in this review
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]