P023 Bereavement Care: Where Do We Begin? A QI Initiative on a Palliative Care Unit

Bereavement care is a recognized core dimension of palliative care. Both the World Health Organization (2010) and the Canadian Hospice Palliative Care Association emphasize the need for supports for caregivers during illness and in their own grief and bereavement. Bereavement care includes the time leading up to, surrounding, and following death. Current state on our PCU is lacking in individualized bereavement care plans, consistent understanding and approach around the types of bereavement care we provide, and lack of local practice guidelines or care pathways to facilitate delivery of needs based individualized care. All patients and caregivers should have access to some level of bereavement care however the challenge is in identifying those at risk for developing maladaptive or complex grief and providing an appropriate level of support within our operational means. Our goal is to improve individualized bereavement care accessible to 75% of caregivers of individuals who are cared for on the SMH Palliative Care Unit. Through screening with a validated screening tool caregivers will be identified for level of bereavement risk and care will be guided by a formal Bereavement Care Pathway. This plan of care helps to provide bereavement support based on level of need as determined by the bereavement screening. Our results from initial internal validation of the tool are summarized here and ongoing data collection continues. QI method with PDSA cycles of rapid improvement. Pilot of bereavement risk screening tool over two weeks (n=17) showed 29% completion compliance (4/17), 21% (3/17) with a LOS LT 24 hours, and 14% (2/17) with no formal caregivers. Majority screened were low risk (11/17) and only 2/17 medium risk. No high risk individuals were identified. Further testing of the screening tool is needed and a broader pilot of the tool and data collection is ongoing.