Implementing routine bereavement follow-up in a tertiary Emergency Department

Ms Joanne Neill1

1Donatelife SA/Royal Adelaide Hospital, Adelaide, Australia

INTRODUCTION: Providing end of life (EOL) follow-up to bereaved families of patients who have died in the Emergency Department (ED) may improve end of life care and reduce relatives’ burden of grief. Follow-up after bereavement is recommended by professional society guidelines. Furthermore, DonateLife Australia recommends routine notification at EOL to DonateLife specialists. A collaboration  between  DonateLife SA (DLSA) and Royal Adelaide Hospital (RAH) ED was established to implement routine follow-up with bereaved families, including notification at EOL to DonateLife specialists.

OBJECTIVES: The primary objective was to determine feasibility of an EOL follow-up service for bereaved loved ones in ED. Secondary objectives were to receive routine notification of all EOL in ED, conduct a routine donor screen, and evaluate loved ones feedback on quality of EOL care.

METHODS: From December 2018, patients at medical consensus of EOL are referred through a 24-hour number to DLSA Donation Specialist Nursing Coordinators (DSNC’s). After patient’s death, a family representative is given a bereavement pack, with a letter outlining the EOL follow-up service, and advising they will be telephoned by a staff member in 6-8 weeks. The telephone interview is conducted by a trained caller based on CAESAR- questionnaire covering patient and family experience of EOL care. Family members can decline involvement at any time.

RESULTS: After 6 months there were 81 EOL referrals.26 participants were due for follow-up calls, 26 had been contacted, 25 surveys completed and 1 declined involvement. Follow-up time averaged 40 minutes per participant. Although each question regarding quality of EOL care scored highly, valuable areas for improvement were identified. Participants viewed the EOL follow-up service positively.

CONCLUSION: A collaborative approach made EOL follow-up feasible, although resource intensive. Families viewed the service as beneficial and it has generated important information.


Jo began her nursing career at RAH in 1984, where she developed a passion for Emergency Nursing. Throughout her 35 years of nursing, Jo has worked primarily in Emergency departments in South Australia until 1989, when she went to  Al Ain, in the United Arab Emirates, and worked in Tawam Hospital ED. In 1997, she moved to Utrecht, in The Netherlands, and after spending six months learning Dutch, did agency work until finding a position in an ED, where she continued working until returning to Adelaide in 2004. Since 2005, she has worked in RAH ED. In October 2018, Jo commenced work with DonateLifeSA (DLSA) in the role of Clinical Nurse, utilizing clinical knowledge and experience to coordinate, implement, educate and  support End of Life Care specific to routine notification at medical consensus of End of Life, an End of Life Follow-up Service and organ and tissue donation within the ED. Throughout her career, Jo has been a keen and passionate advocate of  quality End of Life Care in Emergency Departments, and currently works three days a week in this role.