• 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 Bár... more bara Antunes. less
• 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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