14 A multi-centre QI project identifying and supporting palliative care patients with hearing loss

Background Communication is essential for providing good quality, holistic palliative care. Hearing loss disrupts identification, assessment and treatment of physical, psychological and spiritual problems, independently increasing mortality and adverse health outcomes and negatively impacting patients' quality of life. We evaluated our current practice within an acute hospital and hospice palliative care setting, aiming to improve identification and support for patients with hearing loss. Methods At each site we reviewed case notes from all new admissions or initial assessments over a 2–4-week period. We recorded whether hearing loss and subsequent communication needs were identified and documented, cross-checking this with evidence of hearing loss in primary care records. Following initial data collection, we delivered an education session on hearing loss and added a specific 'communication needs' heading within our initial patient assessment/admission template. Results At the hospital, 30% of our patient caseload had known hearing loss. Prior to interventions we identified hearing loss and documented communication needs in 2% of these patients. Following the intervention period, we identified 57% of patients with known hearing loss and documented communication needs in 52%. At the hospice, 29% of admissions had known hearing loss, but only 12% were identified. Of these, 0% had their communication needs recorded. Intervention has since happened and subsequent data to be collected. Conclusions Simple interventions achieved a significant increase in the identification of patients with hearing loss accessing palliative care services at the hospital site. Next steps include: using results to apply for funding for amplification equipment to improve communication, and possible expansion of the project both a) across the hospital by collaboration with the additional needs and geriatrics teams and b) to further hospital trusts/hospices, to ensure we are screening for hearing loss in all hospital and hospice admissions and providing communication support.