McConnell, T. et al. Factors affecting the successful implementation and sustainability of the Liverpool Care Pathway for dying patients: a realist evaluation. BMJ Supportive and Palliative Care Online – 7 November 2014
The Liverpool Care Pathway (LCP) for the dying patient was designed to improve end-of-life care in generalist healthcare settings. Controversy has led to its withdrawal in some jurisdictions.
The main objective of this research was to identify the influences that facilitated or hindered successful LCP implementation. There is a need to appreciate the organisationally complex nature of intervening to improve end-of-life care.
Successful implementation of evidence-based interventions for end-oflife care requires commitment to planning, training and ongoing review that takes account of different perspectives, institutional hierarchies and relationships, and the educational needs of professional disciplines. There is a need also to recognise that medical consultants require particular support in their role as gatekeepers and as a lead communication channel with patients and their relatives.