Quality improvement project: Bereavement follow-up in an acute hospital during COVID-19 and beyond

Background: Bereavement support is an important facet of palliative medicine. Many patients who receive end of life care in our hospital are not known to the hospice or hospital social workers. As a result, their families and carers do not avail of bereavement follow-up. This is particularly relevant as Covid-19 restrictions have interrupted the traditional community orientated bereavement process. Aim and objectives: The goal is to quantify this cohort and facilitate a collaborative MDT quality improvement approach to acknowledge and address bereavement follow-up in the context of Covid-19 and beyond. Methods: We quantified the weekly average number of families or carers who would not avail of bereavement follow-up prior to and during the Covid-19 surge. We reviewed the advice regarding bereavement support as per the Irish National Clinical Program for Palliative care 2018. The palliative team discussed this service gap with different stakeholders including the hospice, cancer care west, medical social work and the bereavement officer. A number of quality improvement methods were employed;such as stakeholder map, fishbone analysis, driver diagrams and the 5 whys. Results: The average weekly number of families/carers who did not avail of bereavement follow-up prior to Covid-19 was 3 and during the Covid- 19 surge was 10. Quality improvement methodologies revealed that the gap in bereavement follow-up was due to a lack of a palliative care social worker. To address this gap short-term a bereavement information leaflet was designed which will promote self-recognition of prolonged grief and signpost options available for support. Conclusion: Bereavement support is an important component of palliative care, which is often lacking. This project utilised a multidisciplinary quality improvement approach to improve this service gap with a bereavement information leaflet in the short-term and a long-term plan aimed at funding a palliative care social worker. P Posters Volunteering.