• Palliative medicine · Mar 2017

    Implementing a patient-centred outcome measure in daily routine in a specialist palliative care inpatient hospital unit: An observational study.

    • Alze Pereira Dos Santos Tavares, Carolina Paparelli, Carolina Sassaki Kishimoto, Silvia Avo Cortizo, Karen Ebina, Mariana Sarkis Braz, Sandra Regina Gonçalves Mazutti, Marcio José Cristiano Arruda, and Bárbara Antunes.
    • 1 Hospital Paulistano, Sao Paulo, Brazil.
    • Palliat Med. 2017 Mar 1; 31 (3): 275-282.

    BackgroundGathering clinical evidence data on patients' palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread.AimTo implement a patient-centred outcome measure in daily practice and fulfil one quality indicator: improve pain during the 72 h after admission, in at least 75% of patients.DesignAn observational prospective study. The Palliative care Outcome Scale was used at admission (T0), third day (T1) and weekly.Setting/ParticipantsHospital palliative care unit with 17 individual rooms. All patients admitted to the unit were included in the study.ResultsPreliminary results ( N = 84) revealed inconsistent and missing data (14%). Symptoms were sub-optimally controlled by T1. Processes changed, and only a team member could apply Palliative care Outcome Scale. Doctors were encouraged to grasp the meaning of Palliative care Outcome Scale results for each patient. The post-pilot included 317 patients. No missing data occurred. There was an improvement in most items between T0 and T1: 'pain' and 'other symptoms' presented statistical significant differences ( p < 0.05).ConclusionImplementing a patient-centred outcome measure in a hospital palliative care service is feasible and improves quality of care. Controlling high pain at T0 improved (>80%) by T1. Results became more consistent and symptom control was improved overall. Patients are evaluated based on holistic domains by an interdisciplinary team and we have added a much needed measure to help guide improvement of the quality of care provided.

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