Background The Palliative Performance Scale (PPS) is a validated tool used to assess functional ability of palliative care patients. The PPS is mainly used in hospices, there is little evidence about its feasibility in hospital palliative care units (PCUs). Better understanding of the feasibility of using the PPS in hospital PCUs could improve documentation of outcome measures to support palliative care delivery.
Aim To explore the feasibility of using the PPS in a 12-bedded hospital PCU in Northwest England.
Methods We used Plan-Do-Study-Act (PDSA) cycles to implement the PPS. We developed online education materials for staff training and development. We introduced the PPS into clinical practice in stages over three months. We used the PPS twice weekly to identify functional changes in patients over time. We distributed an online questionnaire to staff at baseline, three weeks and three months to determine their perceived usefulness and confidence in using the PPS.
Results Initially we used the PPS in 33% (n=4/12) of in-patients, followed by 66% (n=8/12), then 100% (n=12/12). In total, we conducted PPS assessments for 84 patients over three months. Patients had various malignant and non-malignant diagnoses. Thirteen staff completed the baseline questionnaire and eight completed the post-implementation questionnaire at three months. Staff-reported confidence (mean scores) in using the PPS increased at three months compared to baseline (9.25 vs 7.9; scale of 1=not at all confident to 10=very confident). Staff considered the PPS to be useful at three months and baseline (mean scores; 8.6 vs 8.5; scale of 1=not at all useful to 10=very useful).
Conclusion The PPS was introduced successfully and is now part of routine holistic care. It is feasible to use the PPS to assess functional ability of patients in hospital PCUs. We plan further work exploring how effective documentation and use of validated outcome measures in palliative care can support delivery of hospital-based palliative care.
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