Background The Dudley Group NHS Foundation Trust (DGFT) integrated Specialist Palliative Care Team work across hospital and community and use Somerset to record contacts including documentation of preferred place of care. The team have used improvement methodology to improve quality and appropriateness of referrals.
Method The SPCT use Somerset Cancer Register to record contacts and working with the data analysts at DGFT the team have agreed where to record outcomes so that this can be reported on a monthly basis and used to drive improvements. Statistical Process Control (SPC) methodology is used and targets set regarding improvements. An Excel spread sheet is also provided to enable the team members to identify any gaps in data collection
Results The results have demonstrated improvements with regards to achievement of preferred place of death (mean 75%), proportion of referrals accepted (mean 74%). The team have robust discharge criteria and we are able to report on the proportion of discharges re-referred within 7 days of discharge from the hospital caseload (mean 2%) or within 30 days from the community caseload (mean 8%). The data has also demonstrated that within the hospital and community caseload the majority of referrals are for cancer patients.
Conclusion The metrics can now be further developed to include other outcomes including number of advance care plans offered, number with priorities with care, Gold Standards Framework status and phase of illness at referral to review the complexity of referrals.
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