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
| 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] | ||