title: Evaluating a fast-track discharge service for patients wishing  to die at home.
abstract: BACKGROUND
  The UK Department of Health's End of Life Care Strategy highlighted the low percentage of patients who achieve their wish to die at home (~20%). Figures in south west London were below the London regional average. This paper reports an attempt to improve the proportion of patients from one hospital in the area achieving their preferred place of death.
  
  
  METHODS
  A funded initiative by two local primary care trusts allowed the development of a 7-day-per-week fast-track discharge service provided by the hospital palliative care team. The hospital team acted as coordinators, ensured that the correct medication and equipment would be available at the home, and personally transferred the patients to community services.
  
  
  RESULTS
  Data is presented from the first representative period of fast-track discharging (June 2009-July 2010). A total of 110 discharges were facilitated over this time, with the rate increasing as the service developed. The vast majority of discharges occurred within 72 hours, and a significant number (~20%) occurred within 24 hours.
  
  
  CONCLUSIONS
  The data indicate that the new service is effective. There are logistical problems in providing such a service and these are discussed. Further work is required to determine the feasibility of extending this service model to other acute hospitals and to evaluate its health-economic impact.
authors: Division of Population Health Sciences and Education, St. Georges University of London, Cranmer Terrace, London, England.
authors: Berit
authors: B
authors: Moback
authors: Ruth
authors: R
authors: Gerrard
authors: Ollie
authors: O
authors: Minton
authors: Janet
authors: J
authors: Campbell
authors: Lucie
authors: L
authors: Taylor
authors: Patrick Charles
authors: PC
authors: Stone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist; D002985:Clinical Protocols; D017598:Efficiency, Organizational; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D010166:Palliative Care / Q000458:organization & administration*; D010351:Patient Discharge; D057240:Patient Preference; D016730:Program Development