title: Evaluating the Liverpool Care Pathway for care of the terminally ill in rural Australia.
abstract: OBJECTIVE
  This study evaluates a pilot implementation of the Liverpool Care Pathway (LCP), a clinical tool used to guide the care of dying patients in the last days of life, on the end-of-life care for dying patients in three regions in rural Australia.
  
  
  METHODS
  The LCP was implemented at 13 participating sites: nine hospitals (general wards), one community-based palliative care service, and three in-hospital palliative care units. To evaluate the implementation of the LCP, 415 eligible patient records were examined: 223 pre-implementation and 192 post-implementation (116 on the LCP and 76 receiving usual care). The primary analysis compared all patients pre-implementation of the LCP versus all patients post-implementation.
  
  
  RESULTS
  Increases were found post-implementation for communication with other health professionals and with patients or family (pre-69 %, post-87 %; p ≤ 0.000), use of palliative medications (pre-87 %, post-98 %; p ≤ 0.000) and frequency of symptom assessments (pre-66 %, post-82 %; p ≤ 0.000). Fewer blood and radiological investigations were conducted and venous access devices used in the post-implementation groups than in the pre-implementation period.
  
  
  CONCLUSIONS
  This study suggests that when rigorously implemented, the LCP improves important components of end-of-life care for dying patients and their families.
authors: Centre for Cancer and Palliative Care Research, School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Blvd., Bldg. 21.460, Joondalup, Western Australia, 6027, Australia. anne.wilkinson@ecu.edu.au.
authors: Anne M
authors: AM
authors: Wilkinson
authors: School of Surgery, The University of Western Australia, Perth, Western Australia, Australia.
authors: Claire E
authors: CE
authors: Johnson
authors: Department of Health, Palliative Care, WA Cancer and Palliative Care Network, Perth, Western Australia, Australia.
authors: Helen
authors: H
authors: Walker
authors: Department of Health, Palliative Care, WA Cancer and Palliative Care Network, Perth, Western Australia, Australia.
authors: Valerie
authors: V
authors: Colgan
authors: Centre for Cancer and Palliative Care Research, School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Blvd., Bldg. 21.460, Joondalup, Western Australia, 6027, Australia.
authors: Hayley
authors: H
authors: Arnet
authors: School of Mathematical Sciences, University of Technology Sydney, Ultimo, New South Wales, Australia.
authors: Tapan
authors: T
authors: Rai
mesh_terms: D000368:Aged; D001315:Australia; D003142:Communication; D019091:Critical Pathways; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D010817:Physician-Patient Relations; D010865:Pilot Projects; D013727:Terminal Care / Q000379:methods*; D019452:Terminally Ill
keywords: Critical pathways; Palliative care; Quality improvement; Quality of health care; Terminal care