Background The outcome measures; Palliative phase of illness, Australian Karnofsky and IPOS were introduced to the hospice in 2016. The deceased IPOS (a reduced 8-point assessment) has recently been introduced to assess patients’ symptoms in the last 48 hours of their lives.
Aims To improve transparency of symptom burden within the dying phase for patients on our inpatient unit with the goals of: (1) Demonstrating the impact of care by the MDT. (2) Identifying learning needs. (3) Highlighting bereavement needs for families.
Methods Through work with an analytics company (BLUEFish) we have been able to produce a visual display of the patient specific deceased IPOS scores directly from the electronic patient record. SystmOne can be configured to include additional menu items (buttons) on the patient record toolbar which give access to the spider diagrams. Outcome measures reporting used at Marie Curie sits outside of SystmOne and by customizing the SystmOne toolbar, users can launch the IPOS Spider diagram report for the current patient with a single click. Button setup is straightforward and, once configured, the new function becomes available to all users. This spider diagram is projected during IPU MDT.
Results Staff have a clear visualisation of the symptoms present during the dying phase.
Conclusion The introduction of the displayed deceased IPOS is improving the quality of our care within the dying phase, and improving engagement with our MDT and counselling team.
Impact on practice
Counselling staff have a greater awareness of symptom and distress levels during the dying phase and therefore the likely impact on bereavement for family members who are referred to them.
The immediate feedback in MDT improves job satisfaction as most deaths are peaceful.
For deaths with higher scoring symptoms, a more thorough review is now undertaken, and learning needs identified.
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