The Implementation of the Acute Basic Palliation Concept in Newly introduced Hospital Departments: An Explorative Observational Study of Non-Specialized Palliative Patients Discharged to Die at Home in Denmark.

Abstract

The Acute Basic Palliation Concept (ABPC) is a multidimensional tool designed to ensure high-quality end-of-life care for patients discharged from hospital. This study aimed to assess the effectiveness of symptom alleviation achieved by departments experienced in using the ABPC compared to departments newly introduced to the concept. Doctors in newly introduced departments (n = 14) used the ABPC following a 45-minute training session. Electronic questionnaires were sent to all healthcare staff involved in end-of-life care of patients discharged using the ABPC with patients included consecutively from January first 2024 to December 30th 2024. Relatives were contacted after the patient's funeral and invited to complete a questionnaire. Patient data were extracted from medical records. Of 100 patients included, 51 were discharged by departments experienced with ABPC and 49 from departments newly introduced to the concept. In 95-96 % of cases, relatives reported that the patients had a dignified death without suffering. Good symptom control for pain, dyspnoea, agitation, and discomfort was frequently reported by relatives (experienced departments: 86-93 %; newly introduced department: 75-80 %; all p-values >0.05). Inadequate symptom relief was rarely reported by relatives, with no significant differences between groups (0-5 %; p-values >0.05). ABPC usefulness ratings were median 92-96 on a 0-100 scale. In conclusion, the use of the Acute Basic Palliation Concept resulted in high quality end-of-life care in both departments experienced with the concept and those newly introduced to it. The concept received highly positive evaluations from healthcare professionals and shows strong potential for broader implementation. Future studies will assess its feasibility in large scale and in general practice.