Background PCOC uses a suite of clinical assessment tools to help identify and manage common symptoms and problems among palliative care patients. They may help patients, carers and families to communicate their experiences and preferences with clinicians and, importantly, to benchmark outcomes. PCOC assessment tools are being adopted widely in the Irish palliative care setting at the moment.
Methods PCOC assessments were introduced in the inpatient specialist palliative care unit at Milford Care Centre in December 2018. 4 separate audits were conducted during this initial period: Phase Definition, Phase Change, Phase Assessment, Problem Severity Score (PSS) Assessment.
Results Phase Definition and Phase Change: Of a total of 127 phases among 10 patients, 91 (71.65%) were correct, 21 (16.54%) were incorrect and 15 (11.81%) were missed. Most errors related to recognition of the terminal phase and recording of a change of phase outside of routine assessment times. Phase and PSS Assessment: These examined the consistency of scores applied by two different clinicians when assessing a patient within two hours. Initially, our compliance rates were approaching those published previously. Following full implementation of training for all clinical staff, a re-audit showed the rate of consistency matched the published rates for all domains except for assessment of ‘other symptoms’ (aside from pain) and ‘family/carer problems.’ The latter improved significantly in the period between data collection.
Conclusions Overall results are very positive and areas for improvement have been identified. Education and dissemination of results to clinical staff is continuing. A positive response to these interventions has been demonstrated. These audits will continue on a regular basis to ensure maintenance of these standards, and improvement where necessary. A further audit of response to PCOC assessments will be conducted.
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