Background Measuring patient outcomes is necessary to assess the impact of care and identify areas for improvement (Etkind, Daveson, Kwok, et al., 2015; Marshall, Haywood, Fitzpatrick, 2006). It is therefore vital that staff are confident and comfortable using outcome measures. Hospice adopted three of the Outcome Assessment and Complexity Collaborative (OACC) (Witt, Murtagh, de Wolf-Linder, et al.) measures in July 2019: the Phase of Illness, Australia-modified Karnofsky Performance Status (AKPS) and Integrated Palliative care Outcome Scale (IPOS). In July 2020, Hospice investigated clinicians’ perceptions of the measures.
Aim To understand clinicians use and views of the OACC measures, any problems and suggestions for improvement.
Methods A survey was distributed to clinicians (n=42). Descriptive statistics were calculated using the statistical packages R and RStudio (Version 4.1.0 for Windows). Qualitative data were analysed using a thematic analysis framework (Braun & Clarke, 2006).
Results Twenty-nine clinicians (response rate 69%) had used one of the three measures at least once. Twenty-five (93%), 22 (85%) and 24 (92%) stated that they use IPOS, AKPS and Phase of Illness some or all of the time, respectively. Moreover, 24 (83%), 23 (79%) and 21 (72%) clinicians felt confident appropriately using IPOS, AKPS and Phase of Illness, respectively.
Respondents identified the measures as a helpful resource for person-centred assessment and monitoring. They can help open up dialogue and increase rapport between patient and clinician, and provide a ‘common language’ between clinicians. However, they felt the measures added little to a clinical assessment, particularly for Allied Health Professionals (AHPs), and an apparent focus on physical health limited holistic assessment.
Respondents recommended increased application of OACC measures at handover. For AHPs, other outcome measures might be considered. Some wanted feedback on outcomes and more training on use of the measures.
Conclusions In a palliative care setting, benefits were witnessed mainly in patient assessment but less in the application of outcomes. Further staff training and application of outcomes may be beneficial.
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