The just-in-case box contains medications for pain-relief that are commonly required at the end of a patient’s life. The boxes are placed in the patient’s home, where doctors and nurses can administer appropriate drugs quickly. The just-in-case box helps to reassure the patient and family that comfort can be maintained at home, as drugs can be given instantly without having to wait for a GP. It was found that the drugs were useful in preventing admission to a hospital or a hospice and help patients to remain and be cared for at home as long as possible.
Audit forms have been completed for all patients by the team that looks after them. This data has been used to measure hospital admissions, out-of-hours calls and patients staying in their preferred place of care. According to this data, NHS Lanarkshire identified that 180 of 219 boxes were used with at least one drug administered as of February 2012, with 84 hospital admissions avoided and 114 out-of-hours calls avoided.
The initiative was rolled out to all areas in Lanarkshire in January 2012 and has since been recognised nationally for its efforts. The project was mentioned in NHS Scotland’s Annual Report (page 66) as an example of key achievements in healthcare quality. The project also won the award for person-centred poster category when it was featured at the NHSScotland Event 2012 as a poster.
Dr Helen Alexander, network manager of the Palliative Care Manage Clinical Network at NHS Lanarkshire, said to STV: “Previously, if someone needed medication then a doctor or clinician would be called to the house to identify the problem, write a prescription and then the family would have to go to the pharmacy.
“Through the ‘Just in Case’ boxes, we have managed to prevent a number of people being admitted to hospital, whether this was in the last days of their life or in the run up to it, and this makes them much more content.”
General information about the just-in-case boxes can be found on the NHS inform website.