Article Text
Abstract
Background Phase of Illness (POI) describes the current stage in the patient’s illness and are classified according to the care needs of the patient. The phases are stable, unstable, deteriorating, and dying. POI are useful to prioritise interventions, manage caseloads and in handovers. POI is documented at every clinical contact by a range of healthcare professionals (HCP); therefore, consistency of assessment is important.
Aim To assess whether there is consistency across the organisation and clinical areas as to how to POI is being used and interpreted.
Method Clinical staff across the organisation were asked to complete two questionnaires. Two fictional patient scenarios were devised for the surveys. HCPs were asked to choose which POI best represented the patient‘s condition, which evolved over time, at each clinical contact by an HCP.
Results Thirty-five HCPs completed scenario 1, 29 completed scenario 2. The range of HCPs included nurses, doctors, physiotherapists, occupational therapists and patient and family services. Majority agreement across all POI assessments in scenario 1. Five of the seven questions having agreement of the phase by over 70%. Less agreement across the POI assessments of scenario 2. Only 2 questions showing agreement by over 70% of the respondents. This was in part due to disagreement when to change from unstable to another POI.
Conclusion POI assessments give a useful description of the patient and families’ current care needs and whether an effective care plan is in place. This survey shows that there is mostly agreement of POI assessment across the multidisciplinary team. More work in terms of staff training and support is required to ensure the consistency of POI assessment across the hospice. The results of the survey have been disseminated to the hospice HCPs with a focus on when to change a POI.