different interventions every month; including Grand round, departmental teaching, posters (Figure 1 ), implementing related questions in the palliative pathway and e-messages. Results After 4 months, 66% of patients with an active ICD/ CRT-D received discussions and switch-offs in advance with good timing before death (Figure 2 ). In turn, there was a strong impact on patient-centred care, quality and co-ordinated care, efficiency, effectiveness, cost and patient safety. Abstract 53 Figure 2

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... nclusions ICDs/CRT-Ds can save lives. However, patients reaching the end of life should be put at ease and comfort by discussing ICD/CRT-D deactivation at DNAR ('Do Not Attempt Resuscitation') discussion and have their ICD/CRT-D switched off in advance with good timing.