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EDEL (Emergency Department End of Life survey)

Author(s) EditorsSaema Saeed
What’s EDEL all about?What was the reason that led to the creation of the EDEL study? And what did we hope to achieve? We know that with an increase in ED presentations of patients presenting with End-of-Life symptoms, there is an existing research need to evaluate and understand the current practices of End-of-Life Care in Irish E.Ds. The goal of EDEL was to capture this data and thereby provide a much valuable insight to End of Life Care in the Emergency Department, in addition to expanding and developing the roles Emergency Medicine Departments in managing patients at end of life, including infrastructure, developing pathways to specialist palliative care, community services and training needs. We designed a cross-sectional electronic survey that was conducted in 23 sites using the ITERN network. And the data collected was enormous! EDEL has been a labour of love, a year in the making, one of the biggest data sets looking at EM doctors and end of life care. This study has highlighted a lack of awareness and knowledge of EOL care particularly among less experienced EM Doctors. We know that there is a willingness to commence EOL pathways and improve standards of EOL care among EM doctors. There is a need for formalised training and education programmes in the provision of EOL care in the ED and this could improve comfort levels and knowledge amongst EM doctors and improve the patient care pathways for patients approaching end of life. We must invest not only to improve our own knowledge in EOL care and resources but most importantly for our patients who deserve the right care at the right time. We know research in end-of-life care is one of the top ten priorities in emergency medicine and we hope our work will inspire the EM community and specialty colleagues to carry on the work.
Key Learning Points / Take Home Message   Top TipsTeamwork makes the Dream work! EDEL had been a team effort involving the ITERN team, IAEM, RCSI, our amazing site leads and regional reps, EM consultants across Ireland and everyone who responded and filled in the questionnaires. Do your homework and ask for help when in the study is at a standstill. Expect and prepare for problems (be it delays in getting ethics approval, recruiting sites). Get in touch with peers who have been through similar hurdles. Ask and ye shall receive!

It’s been a long road and a huge amount of work by all. ITERN are delighted to see the publication of the first Emergency Department End of Life (EDEL) study results. This paper focuses on the views and attitudes of emergency doctors towards the delivery of end of life care in our ED’s.


Here are some key findings from our 23 participating EDs and 311 respondents:

1.     Just 12.6% of respondents agreed that the overall experience of a dying patient and their family is satisfactory.

2.     50% of respondents disagreed that they were happy with the standard of palliative care provided in ED

3.     Although 55% of respondents have provided EOL care to patients in ED,  just 20% reported having any formal training

4.     75.5% of respondents rated their knowledge of EOL care as limited or no knowledge at all


This study has demonstrated a clear willingness and desire by Irish emergency doctors to provide an excellent standard of EOL care to patients, but these desires are limited by knowledge and experience.

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