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Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking.

Currow DC, Allingham S, Yates P, Johnson C, Clark K, Eagar K - Support Care Cancer (2014)

Bottom Line: Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients' outcomes and the consistency of these outcomes have improved in the last 3 years.Nationally collected point-of-care data were anchored for the period July-December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period (n = 30) using individual longitudinal multi-level random coefficient models.Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved.

View Article: PubMed Central - PubMed

Affiliation: Discipline, Palliative and Supportive Services, Flinders University, Sturt Road Bedford Park, Adelaide, SA, 5042, Australia, david.currow@health.sa.gov.au.

ABSTRACT

Purpose: Every health care sector including hospice/palliative care needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients' outcomes and the consistency of these outcomes have improved in the last 3 years.

Methods: Data were analysed by clinical phase (stable, unstable, deteriorating, terminal). Patient-level data included the Symptom Assessment Scale and the Palliative Care Problem Severity Score. Nationally collected point-of-care data were anchored for the period July-December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period (n = 30) using individual longitudinal multi-level random coefficient models.

Results: Data were analysed for 19,747 patients (46 % female; 85 % cancer; 27,928 episodes of care; 65,463 phases). There were significant improvements across all domains (symptom control, family care, psychological and spiritual care) except pain. Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved.

Conclusion: These are the first national hospice/palliative care symptom control performance data to demonstrate improvements in clinical outcomes at a service level as a result of routine data collection and systematic feedback.

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Related in: MedlinePlus

Boxplots showing the distributions of the percent of patient phases at or above baseline by service with clinician-rated measures (Palliative Care Problem Severity Score (PCPSS)) and patient-rated Symptom Assessment Scale (SAS). Data from January 1, 2009 to December 31, 2011; 65,463 phases of care for 19,747 patients
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Fig1: Boxplots showing the distributions of the percent of patient phases at or above baseline by service with clinician-rated measures (Palliative Care Problem Severity Score (PCPSS)) and patient-rated Symptom Assessment Scale (SAS). Data from January 1, 2009 to December 31, 2011; 65,463 phases of care for 19,747 patients

Mentions: For both patient- and clinician-reported outcomes, there were statistically significant improvements in all domains over the 3-year period at a service level with the exception of pain (Table 4). Consistent with this, the median service level percentage of patient phases achieving at least the baseline median change increased incrementally over the period. At the same time, the service level interquartile ranges also decreased in the same domains over the same period of reporting suggesting that not only was overall performance improving but also outcomes were being achieved more consistently (Table 5; Fig. 1).Table 4


Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking.

Currow DC, Allingham S, Yates P, Johnson C, Clark K, Eagar K - Support Care Cancer (2014)

Boxplots showing the distributions of the percent of patient phases at or above baseline by service with clinician-rated measures (Palliative Care Problem Severity Score (PCPSS)) and patient-rated Symptom Assessment Scale (SAS). Data from January 1, 2009 to December 31, 2011; 65,463 phases of care for 19,747 patients
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4289012&req=5

Fig1: Boxplots showing the distributions of the percent of patient phases at or above baseline by service with clinician-rated measures (Palliative Care Problem Severity Score (PCPSS)) and patient-rated Symptom Assessment Scale (SAS). Data from January 1, 2009 to December 31, 2011; 65,463 phases of care for 19,747 patients
Mentions: For both patient- and clinician-reported outcomes, there were statistically significant improvements in all domains over the 3-year period at a service level with the exception of pain (Table 4). Consistent with this, the median service level percentage of patient phases achieving at least the baseline median change increased incrementally over the period. At the same time, the service level interquartile ranges also decreased in the same domains over the same period of reporting suggesting that not only was overall performance improving but also outcomes were being achieved more consistently (Table 5; Fig. 1).Table 4

Bottom Line: Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients' outcomes and the consistency of these outcomes have improved in the last 3 years.Nationally collected point-of-care data were anchored for the period July-December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period (n = 30) using individual longitudinal multi-level random coefficient models.Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved.

View Article: PubMed Central - PubMed

Affiliation: Discipline, Palliative and Supportive Services, Flinders University, Sturt Road Bedford Park, Adelaide, SA, 5042, Australia, david.currow@health.sa.gov.au.

ABSTRACT

Purpose: Every health care sector including hospice/palliative care needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients' outcomes and the consistency of these outcomes have improved in the last 3 years.

Methods: Data were analysed by clinical phase (stable, unstable, deteriorating, terminal). Patient-level data included the Symptom Assessment Scale and the Palliative Care Problem Severity Score. Nationally collected point-of-care data were anchored for the period July-December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period (n = 30) using individual longitudinal multi-level random coefficient models.

Results: Data were analysed for 19,747 patients (46 % female; 85 % cancer; 27,928 episodes of care; 65,463 phases). There were significant improvements across all domains (symptom control, family care, psychological and spiritual care) except pain. Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved.

Conclusion: These are the first national hospice/palliative care symptom control performance data to demonstrate improvements in clinical outcomes at a service level as a result of routine data collection and systematic feedback.

Show MeSH
Related in: MedlinePlus