The Welsh Collaborative Care Pathway Project: Implementing an Integrated Care Pathway for the Dying Patient in Wales

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Abstract
The primary goal of this project was to improve the care of the dying patient through the introduction of a pre-developed integrated care pathway (ICP), while concurrently seeking to determine the feasibility of implementing a pre-developed ICP throughout Wales. Thirty-eight teams, reflecting four care settings crossing the statutory and voluntary sectors, participated in the project. Training was delivered on a regional basis in the north, south and middle areas of Wales. Participating teams' implementation of the ICP was monitored for one year. Support was provided by quarterly regional meetings, a project website, quarterly newsletters and a telephone helpline. After one year, 80% of the 38 teams participating in the project were using the ICP in their workplace. A further 10% were prepared and ready to use the ICP when a suitable patient was referred, while only 10% were unable to implement the ICP. The feasibility of implementing a pre-developed care pathway for the last days of life across different care settings and sectors throughout Wales was clearly demonstrated. The central collection and analysis of variance sheets established a baseline measure of palliative care quality, facilitated local and national benchmarking, and indicated future directions for research and development to improve the care of the dying patient in Wales.

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