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P134 Pilot service evaluation survey to demonstrate ‘quality & efficiency’ of ‘hospice in-patient care’
  1. Marie Joseph and
  2. Alice Goldhill
  1. St Raphael’s Hospice, North Cheam, UK


Introduction Patients with uncontrolled symptoms will experience impaired quality of life [QoL].

Improvement in symptom management, therefore will lead to an improved ‘QoL’ which is one of the ultimate goals of management of patients in the palliative care setting.

The ‘WHO performance scale/status’{PS}, is designed to measure the ‘QoL’ of patients in the above setting.

It is measured between 0 and 4. [0---normal; 4---totally bed/chair bound, with gradations in-between]

{Note: The higher the value of the ‘PS’, the lower the ‘QoL’ of the patient.}

Aim To demonstrate improvement in ‘QoL’ following successful symptom management

Methods Survey all in-patient admissions to the hospice for ‘symptom control’ purpose

Identify symptoms on admission

Record ‘PS’ as a measure of patient’s ‘QoL’, on admission & on discharge

Record relevant clinical & therapeutic management measures

Pilot survey period:

Approximately 6 weeks

Results 14 patients were admitted for ‘symptom control purpose’.

Neuropathic pain, poor pain control [commonest], nausea and vomiting, shortness of breath, anxiety/low mood, constipation were the identified symptoms.

‘OPIOID switch’, Neuropathic Analgesic Agents, Continuous Sub-Cutaneous Infusion [CSCI/syringe driver], were the common therapeutic measures used.

Average PS on admission was: 2.7 {approximately 3}

Average PS on discharge was: 2.2 {approximately 2}

All patients were discharged home with an improved ‘PS’ indicating an improvement in their ‘QOL’ in comparison to the state on admission.

3 patients subsequently died at home.

Discussion/Survey implications This pilot survey demonstrates to the Clinical Commissioning Groups [CCGs], an evidence of ‘quality and efficiency of hospice in- patient care’.

The findings in addition strengthen ‘staff morale’ in caring for patients in the hospice setting.

Conclusion PS’ as a measure of ‘QoL’ can be a marker of good symptom management in palliative care.

April 2013

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