End of Life Program

Last Days of Life Toolkit

In 2011-12, there were 50,500 deaths in New South Wales with just over 50 per cent of deaths occurring in the acute care setting [1]. Increasingly the type of care and services utilised by these patients is being examined especially in relation to their care in the last days of life.

Evidence from the NSW Between the Flags (BTF) program, as well as from incident reports and Root Cause Analyses, describes the failure of treating teams to identify patients at risk of dying, and then develop & document appropriate treatment plans and communicate appropriately with patients and carers.

Scope and purpose of the toolkit

A pilot of the Calvary Mater Hospital, Newcastle (CMN) Care of the Dying Observation Chart demonstrated that there is a need for not just an observation chart but a suite of tools that will support clinicians in caring for the dying patient.

The CEC will develop a last days of life toolkit that includes:
  • a symptom assessment and management chart;
  • tools to prompt communication;
  • guidelines for standardised approach to medications for the dying patient; and
  • transition to die at home

Supporting resources and education strategies will be developed alongside each of the tools.

Development of the toolkit

Clinicians from all relevant disciplines throughout NSW have participated in specific working parties to review current practice and literature and have made recommendations for each tool development and piloting. The tolls are currently being piloted and will be completed in December 2016.


[1] Australian Bureau of Statistics, http://www.abs.gov.au