| The GSF After Death Analysis (ADA) is a web-based audit and improvement tool based on the Gold Standards Framework (GSF) and is in complete alignment with the Department of Health draft quality markers. End of life care is a very difficult area to measure and an even more difficult area in which to assess progress. However, measurement and audit against accepted standards is a very powerful tool to improve the quality of care provided by an organisation such as a general practice or care home. ADA SITE FOR DATA ENTRY To access the ADA data collection site for registered users please click here | | | | | | | | | | | | |
Prof Keri Thomas introduces the After Death Analysis Audit tool |
ADA is a highly regarded and simple to use online audit which looks at actual care given to patients from the perspective of the practice or care home. Softer quality indicators such as ‘caring shown’ or ‘confidence’ are equally important but are not part of ADA. ADA does not at this time include direct patient feedback. Future developments include use of audit measures before death so that individual patient care improvements can result. Some indicators are about documentation. Many GPs say ‘I carry that information in my head’ but this makes team co-ordination of care difficult, makes it impossible for others to continue care and understandings can be mistaken or change.
ADA measures the effectiveness of practice systems by looking at specific Key Topics:
1. Patient Choice:
- Numbers having advance care plannning discussions
- Numbers dying where they chose or their usual place of care
- Reasons they might die elsewhere
2. Hopitalisation:
- Hospital bed days and crisis admissions
3. Pre-planning of care:
- Anticipatory prescribing
- Out of hours forms sent
4. Local Services
- Use of gaps in service provision
- Bereavement Care offered
5. Systematic
- Benefits advice offered
ADA is recommended in the National End of Life Care Strategy (July 2008) as a useful measurement tool and is endorsed for use in primary care by the Royal College of General Practitioners. Developed six years ago as part of the GSF Programmes in collaboration with the University of Birmingham, ADA has been refined and improved following in-depth evaluation. It can now be used in a wide range of settings to assess and improve care provided for patients nearing the end of life.
PCTs increasingly need to identify those factors which influence key clinical outcomes. ADA PCT reports give an area level overview to help direct funding to the best places so that commissioning meets local strategic targets. It measures key factors such as:
- unscheduled hospital admissions
- place of death and
- patients dying in their preferred place.
| What to do next - Commissioning ADA for your area | | If you are considering use of ADA in your area do ring and discuss your situation and how ADA may help you. ADA can be commissioned through the National GSF Centre CIC. For initial enquiries and to discuss details of your requirements please contact 01743 291891 or Email PLEASE NOTE – the GSF Centre would like to thank the team at Omega (National Association for End of Life Care) for their excellent support in the maintenance of the ADA online service over the last 20 months and also the University of Birmingham before then. As from 1st October 2010 the GSF ADA programme will be brought together with all other GSF programmes under one roof at the National GSF Centre CIC. Any future enquiries related to commissioning should be directed towards the National GSF Centre CIC who will be managing its use and developing it further in future: ada@gsfcentre.co.uk, info@gsfcentre.co.uk, pam.poole@gsfcentre.co.uk You can review the results of the End of Life Care in Primary Care 2009 National Snapshot (Key Findings / Executive Summary) |
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