{
  "abstract": "Background Identifying patients who are sick enough to die can be challenging, with management plans often focusing on active treatment. Patients can often deteriorate out of hours and their care managed by clinicians outside of their usual team. Some nationally recognised communication tools including the AMBER care bundle (Assessment, Management, Best practice, Engagement, Recovery uncertain) developed by Guy’s and St Thomas’ NHS trust encourage honest communication early. It can prompt early documentation of treatment plans for those identified with clinical uncertainty of recovery, as well as resuscitation status and level of escalation, aiding communication between the patient and their clinical team. This can lead to overall improved quality of patient care and their family’s experience.Aims Audit project aimed to evaluate current practice in managing hospital inpatients identified as sick enough to die and identifying a potential need for a recognised communication tool to encourage and educate staff in addressing end of life conversations to improve the quality of patient care.Methods Data collected for 38 inpatients across 10 wards within one hospital trust in July 2024. Data extracted from MediTech analysed against 12 set criteria using the AMBER care bundle version 4.0, with results collated into Excel as percentage of patients meeting each criterion.Results Three criteria achieved 100%, with the remaining eight criteria ranging from 29-92%. The average percentage of patients covering each criterion was 73%. Discussing uncertain recovery with the patient or their next of kin was achieved in 37% of cases.Conclusions Identifying patients who are sick enough to die does not always reflect in communication towards the patient and their families. The use of a structured communication tool would aid in early conversation, improve staff confidence in approaching difficult conversations and result in overall better quality of care delivered to patients with uncertain recovery.",
  "authors": [
    {
      "affiliations": [
        "South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK"
      ],
      "name": "Chad Dawson"
    },
    {
      "affiliations": [
        "South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK"
      ],
      "name": "Mark Lee"
    }
  ],
  "title": "P-07 Evaluating the management of patients with clinical uncertainty of recovery using a recognised communication tool (the AMBER care bundle)",
  "uid": "9461b150-2995-5c50-8641-bd91dbba82ad"
}