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Background: Caring for patients being severely ill and die in hospital make high demands on all professionals and is characterized by uncertainty, individual and social values. This affects the seriously ill and dying patients.
In 2005, the first German translation of the former Liverpool Care Pathway (LCP) was implemented throughout Kantonsspital St.Gallen (KSSG) as part of the palliative approach – in close collaboration with the Marie Curie Palliative Care Institute Liverpool. The comprehensive approach is guided by the interprofessional Palliative Care coordination group, medical and nursing multipliers guarantee a broad dissemination. A training program and palliative consultation service helps to maintain the best possible quality of care for seriously ill and dying patients.
Development: From 2007 the Centre of Palliative Care at KSSG was Coordination Centre for implementation of the pathway in the German speaking area. Since 2008 there is a close cooperation with the Centre of Palliative Care at the University Hospital of Cologne and several institutions in German-speaking countries (DACH). 2012/ 2013 a revised document is used first called “Best care for the dying”, since 2015 Handlungsempfehlung Sterbephase (HES). This last version is a simplified document adapted to the needs of the clinicians. The pathway has been implemented in 14 resp. 36 institutions (different settings) in Switzerland and Austria resp. Germany.
Advancements in German speaking area are: Since 2013 the two centres for Palliative Care St.Gallen (document, education, national and international collaboration) and Bern (research and international collaboration) are responsible for CH and A. Swiss recommendation for care of the dying person has been developed (available on www.palliative.ch). An education-programme for the implementation of HES provided by Centre of Palliative Care St.Gallen including counselling and support of interested and registered institutions ensures not only best practice but also to connect it to the quality governance framework of an organisation.
In Germany, a chapter “Dying phase” in the National Guideline for cancer patients has been developed.
Conclusion: HES promotes best care until death and beyond and helps to dispel the taboo of dying in an acute hospital - looking at death and dying as a natural part of life. By supporting communication among all involved persons, dying in a peaceful and secure atmosphere is possible.