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J Pain Symptom Manage · Mar 2024
Pilot Implementation of the Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool.
- Bethany Russell, Jennifer Philip, Janet Phillips, Amanda Smith, Anna Collins, and Vijaya Sundararajan.
- Palliative Nexus Research Group (B.R., Je.P., A.C.), University of Melbourne & St Vincent's Hospital Melbourne, Melbourne, Australia; Department of Palliative Care (B.R., Je.P.), St Vincent's Hospital Melbourne, Melbourne, Australia. Electronic address: beth.russell@svha.org.au.
- J Pain Symptom Manage. 2024 Mar 1; 67 (3): 260268.e2260-268.e2.
ContextSpecialist palliative care services must balance provision of needs-based care within resource restraints. The Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool is a novel, evidence-based, 7-item prioritization tool, with recommended response times for any given score.ObjectivesTo investigate the acceptability and appropriateness of the RUN-PC Triage Tool implemented into clinical practice.MethodsA single-arm, multisite, prospective implementation pilot conducted at 12 community/inpatient palliative care services, using Quality Improvement methodology with Plan-Do-Study-Act cycles. Data collected for each triage episode included demographics, scoring, user feedback and clinical outcomes. Group differences were tested by chi-squared, Wilcoxon Rank Sum or Kruskal Wallis tests.ResultsA total of 5418 triage episodes were captured, 1509 with outcome data. Referrals to inpatient services were of higher acuity than those to community (median score 24 vs. 14). Whilst high numerical scores were unusual, a significant proportion of cases were clinically urgent. Admissions occurred within recommended response times in over 80% of triage episodes; 5.8% of referred patients died before being admitted. Users reported the tool was easy to complete (99.3% of applications), rarely requiring additional time (0.07%), and appropriate in its triage determination (96.0% of applications).ConclusionThe RUN-PC Triage Tool is feasible to implement, with high clinician acceptability and virtually no additional time required. The recommended response times are feasible and highlight target areas for improvement. Implementation of the tool enables palliative care services to better characterize their referral population and, in turn, improve transparency around access to care.Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.
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