The Liverpool Care Pathway — Improvement In Quality Of End-Of-Life Care
Death in hospital remains very common for cancer patients in developed countries. Although hospital surveys show that death was highly expected, patients dying in hospital have a high probability of unrelieved and poorly treated physical suffering, and emotional, spiritual and social distress. Quality improvement programs in the United States and United Kingdom suggest that aspects of the ‘excellent practice’ of palliative care can be transferred to other settings. The Liverpool Care Pathway (LCP) for the dying patient is one pathway that seeks to achieve this. It offers a structured program aimed at providing improvements in the quality of care for all relevant dimensions at the end of life.
This study aims to assess the effectiveness of the LCP on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital. It implements an uncontrolled before—after intervention cluster trial performed within four hospital wards participating in the pilot. A total of 2 months after the patient’s death, bereaved family members were interviewed. The results provide the first robust data collected from family members, in any reasonably sized sample, of a potential clinically significant improvement in some aspects of quality of care — in particular respect, kindness and dignity, family emotional support, self-efficacy of the family and coordination of care.
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