| Title: | Understanding hospital Admissions Close to the End of life (ACE) Study |
| Project Description: | National and local NHS policy has a major focus on reducing deaths in hospital, particularly deaths shortly after admission, which are seen as “avoidable”, “inappropriate”, “preventable”, expensive, contrary to patient preference and a reflection of inadequate services in the community and in care homes. In practice, the decision-making processes that lead to hospital admission shortly before death are often complex and challenging, occur at points of crisis and can involve multiple decision-makers, particularly when patients are elderly and have illnesses in which prognostication is difficult. Most of the limited research concerning such hospital admissions has been quantitative in nature.The ACE (Admissions Close to the End of life) study is a qualitative investigation of the decision-making processes of community, ambulance and hospital healthcare professionals and care home staff involved in such admissions, with the perspectives of next of kin after the death and health service commissioners. Up to 20 recently deceased patients will be identified through hospital bereavement care services, with healthcare professionals from community and acute settings involved in the admission identified from hospital records. Up to five professionals will be interviewed concerning each case shortly after the death with the deceased patient’s next of kin approached for interview after 3 months. |
| Project organisation | |
| Start date: | 1st September 2012 |
| End date: | 31st December 2017 |
| Contact person: | Dr Stephen Barclay |
| Contact Details: | Primary Care Unit Institute of Public Health University Forvie Site, Robinson Way Cambridge Cambs CB2 0SR UKTelephone: (01223) 763082Fax: 01223 762515E-mail: sigb2@medschl.cam.ac.uk |
| Collaborative: | Research Assistant & PhD student: Sarah Hoare PhD supervisors: Dr Stephen Barclay and Prof Mike Kelly |
| Funding information | |
| Funding Organisation: | National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research & Care (CLAHRC) East of England |
| Funding Amount: | £75,994 |
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| Further Information, References and Publications | |
| ACE is the focus of Sarah Hoare’s PhD research. Sarah is conducting a medical sociology study of end-of-life hospital admissions by exploring the interaction of individuals, professional groups and organisations involved in these admissions.
Morris, Z,S., Fyfe, M., Momen, N., Hoare, S. and Barclay, S. (2013) ‘Understanding Hospital Admissions Close to the End of Life (ACE) Study’ BMC Health Services Research. 13 (89) available from: http://www.biomedcentral.com/1472-6963/13/89 Hoare, S., Morris, Z. S., Kelly, M. P., Kuhn, I., & Barclay, S. (2015). Do Patients Want to Die at Home? A Systematic Review of the UK Literature, Focused on Missing Preferences for Place of Death. PloS One, 10(11), e0142723. doi:10.1371/journal.pone.0142723 |
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