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This chapter discusses how to use the Liverpool Care Pathway for the Dying Patient (LCP). It determines how and why the LCP was developed. The LCP's variances and components are also discussed. The chapter provides a hospital version of the LCP, which shows the forms for the initial assessment, ongoing assessment, and the verification of death.

This chapter discusses the implementation of the Liverpool Care Pathway for the Dying Patient (LCP) in hospitals, hospices, communities, and nursing homes. It looks at the reasons why the LCP should be implemented in these places and what factors are involved during its implementation. The chapter also identifies the specific challenges in implementing the LCP and the benefits of each setting.

This chapter discusses the analysis and feedback of the data recorded. This is an important aspect of the implementation of the Liverpool Care Pathway for the Dying Patient (LCP). Other ways to analyse and collect the data are studied, and the authors determine whether the LCP can be used for patients without cancer. The chapter also asks whether integrated care pathways can be developed for other aspects of palliative care, and studies the role of the LCP in research and development. Future developments in the LCP and its use in teaching and education are also discussed.

This chapter discusses a dissemination and sustainability strategy for the Liverpool Care Pathway for the Dying Patient (LCP) programme in incorporating a model for national audit for care of the dying. It first takes the national clinical audit in context before considering the impact of national clinical audit. It shows that the measurement of quality to drive sustained improvement is important for a high-performing healthcare system, and that data can be a powerful tool for improving quality of care.

This chapter discusses introducing and implementing LCP in other countries. In order for Liverpool Care Pathway for the Dying Patient (LCP) to be successfully implemented, it requires strong and consistent leadership. The chapter also describes the different international activities of the LCP, including its different levels or phases: induction, implementation, dissemination, and sustainability.

This chapter discusses an outline of the various elements of the Liverpool Care Pathway for the Dying Patient (LCP) document and the process through which successful implementation of the LCP for care in the last hours or days of life can be achieved by using the ten step Continuous Quality Improvement Programme. It also explains the fundamental aspects throughout the ten step programme, such as the use of local audit to promote quality assurance.

Liquid crystals (LCs) may be divided into two subgroups: (1) lyotropic LCs, formed by mixing rigid rodlike molecules with a solvent, and (2) thermotropic LCs, formed by heating. One finds in the literature such terms as mesomorphs, mesoforms, mesomorphic states, and anisotropic liquids. The molecules in LCs have an orderly arrangement, and different orders of structures (nematic, smectic, or cholesteric structure) have been observed, as schematically shown in Figure 9.1. The kinds of molecules that form LCs generally possess certain common molecular features. The structural characteristics that determine the type of mesomorphism exhibited by various molecules have been reviewed. At present, our understanding of polymeric liquid crystals, often referred to as liquid-crystalline polymers (LCPs), is largely derived from studies of monomeric liquid crystals. However, LCPs may exhibit intrinsic differences from their monomeric counterparts because of the concatenation of monomers to form the chainlike macromolecules. The linkage of monomers inevitably means a loss of their translational and orientational independence, which in turn profoundly affects the dynamics of polymers in the liquid state. These intramolecular structural constraints are expressed in the flexibility of the polymer chain. Generally speaking, the chemical constitution of the monomer determines the flexibility and equilibrium dimensions of the polymer chain (Gray 1962). Figure 9.2 illustrates the variability of chain conformation (flexible chain, semiflexible chain, and rigid rodlike chain) forming macromolecules. Across this spectrum of chain flexibility, the persistence in the orientation of successive monomer units varies from the extreme of random orientation (flexible chains) to perfect order (the rigid rod). Hence, efforts have been made to synthesize LCPs that consist of rigid segments contributing to the formation of a mesophase and flexible segments contributing to the mobility of the entire macromolecule in the liquid state (Ober et al. 1984). From the point of view of molecular architecture, as schematically shown in Figure 9.3, two types of LCP have been developed: (1) main-chain LCPs (MCLCPs), having the monomeric liquid crystals (i.e., mesogenic group) in the main chain of flexible links, and (2) side-chain LCPs (SCLCPs), having the monomeric liquid crystals attached, as a pendent side chain, to the main chain.