The rapid discharge pathway for the dying patient is an integral part of the Department of Health’s End of Life Care Strategy. It is aimed at patients who are thought to be in the last 72 hours of life, although there is no clear guidance about identifying such patients.Background
The aim of this prospective service evaluation was to review the outcomes of patients started on the rapid discharge pathway for the dying patient.Methods
Data was prospectively collected on all patients started on the rapid discharge pathway during a six month period (February – July 2016) at a medium sized district general hospital with associated cancer centre. Data collected included: date of referral for rapid discharge; date of discharge; date of death; place of death; readmissions; demographic details.Results
24 patients were referred for the rapid discharge pathway, 23 were thought to be appropriate for RDP (9 patients with non-malignant disease, 14 patients with cancer). 18 patients were discharged home, whilst 5 patients died in hospital (all within 72 hours). Of the 18 patients discharged 16 have died (7 within 72 hours, 9 after more than 72 hours). In total 17 out of 23 patients died within 72 hours. No patients were readmitted to hospital.Conclusion
The rapid discharge pathway can help facilitate discharge home for patients in the last days of life. However prognostication can be challenging, especially differentiating between patients who will die within 72 hours (more difficult) than patients who will die within 1 week (less difficult).