Introduction The hospice identified the positive value of outcome measurement in developing an evidenced based approach to care and to demonstrate the difference its care made.
Improve understanding of outcome measurement in palliative care
Ensure competence in using Integrated Palliative Outcome Score (IPOS)
Support change and embed new practise
Method Introducing patient reported outcome was a quality improvement priority for the hospice and was led by the clinical effectiveness group.
A specialist workshop describing the implementation and use of IPOS was created.
The electronic patient record, Crosscare, had IPOS embedded into assessment windows.
Awareness and training sessions were delivered by staff members with knowledge of IPOS to all clinicians working within the In-patient Unit (IPU).
A flow chart for the use of IPOS on the IPU was devised to support practice.
A pilot phase of two months allowed supported implementation and continued concentrated awareness with an additional monthly open forum for all staff.
Patient feedback monitored.
Results Use of IPOS on admission to IPU and at agreed time intervals has been implemented.
Over a period of 6 months use of IPOS has been embedded in to practise.
Patient feedback collected with a 100% of users confirming that using IPOS prior to seeing the admitting clinician helped them to clarify their problems.
The open monthly forum identifies questions and issues on the use of IPOS, highlighting further use in daily care provision and informs future training and support needs.
Flow chart revised providing greater clarity.
Clinical audit around adherence to guidelines.
Conclusions Through a process of training and supported practice, the hospice has implemented the use of a validated outcome measurement within its IPU. Oversight by the clinical effectiveness group ensured responsibilities were clear and the process monitored and evolved successfully.