Background Using clinical outcome measures helps support the delivery of high quality care which is amenable to critical evaluation. The project aims were to: identify potential outcome measures; pilot them within clinical settings; and provide recommendations regarding routine clinical use within a SPCS.
Methods Potential outcome measures were identified and critically evaluated. Three instruments - Palliative care Outcome Scale version 2 (POS-2); Palliative Performance Status (PPS); and Edmonton Functional Assessment Tool (EFAT) – were further assessed in a 2 month pilot within in-patient; out-patient; day therapy and outreach services. Each instrument was assessed on two consecutive occasions (unless the patient died or was discharged).
Results From 97 patients, 52 (54%) were female and mean age was 68 years (range 27–89 years). POS-2 scores ranged from 1–27 (total score 40=very symptomatic and distressed) with highest scores present for in-patients. Seven patients had POS-2 score >20. All expressed high levels of psychological distress for themselves and their family.
Seventeen (73.9%) of the 25 in-patients had a low PPS score (<50%=considerable assistance needed for self-care). For 9 in-patients with a length of stay >14 days, all bar one had a low PPS score on admission.
EFAT scores showed highest levels of dysfunction were for outreach and in-patients. EFAT's ability to sufficiently discriminate clinically meaningful variations in function within each care setting limited its recommendation for regular use.
Day therapy patients tended to have the lowest POS-2 and EFAT scores.
Conclusions Following this project, POS-2 and PPS have been incorporated into routine clinical practice within the day therapy unit and more recently in-patient unit. Initial reflections suggest they aid multi-disciplinary team working and highlight particular patient concerns requiring interventions. PPS scores could potentially be linked with length of stay to help anticipate patients with particular complexity and dependency.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.