Poster Presentation New Zealand Association of Plastic Surgeons Annual Scientific Meeting

Palliative care involvement in the death of plastic surgery inpatients (849)

Rebecca McLean 1 , Terrence Creagh 1
  1. Canterbury District Health Board, Christchurch, CHRISTCHURCH, New Zealand

Background: Deaths among patients admitted under Plastic Surgery are relatively rare events in Christchurch Hospital. The authors wanted to review all recent mortalities and evaluate whether the patient received appropriate input and advice from Palliative Care specialists.

Method: Patients who died while an Inpatient admitted under the care of a Plastic Surgeon from May 2013 to April 2018 were identified via medical coding and notes retrieved and read by the author.

Results: Over the 5 years reviewed, 11 patients died while they were admitted under Plastic Surgery, an average of 1.83 per year. 72.7% of patients had Plastics Ward based care. Male patients accounted for 63.6% of deaths. Of the total 11 patients, five (45.5%) had formal Palliative Care team input which ranged from 2-10 days per patient prior to death, with an average of 4 days spent with each patient and their family. This included discussion with the patient about ongoing wishes, medication management, family meetings and Multidisciplinary team co-ordination.

Discussion: In the last days of life there can be significant physical, emotional and social distress and the use of Palliative Care Specialists and care plans can reduce suffering and improve end of life care. Patients and their families can be supported in their last days while optimising medication management and communication with medical teams.

Conclusion: Situations including sudden unexpected death and ICU care of patients mean that Palliative Care input is not always required. Less than half of patients had Palliative Care input who died under Plastic Surgery in the last 5 years despite 72.9% having ward based care which could be improved on by early identification and referral of palliative patients to improve end of life care.

  1. Intervention to Improve Care at Life's End in Inpatient Settings: the BEACON Trial. Bailey et al. J Gen Intern Med. 2014 Jun; 29(6):836-843