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P-188 Medical team accountability
  1. Tricia Needham
  1. Dorothy House Hospice, Bradford on Avon, UK


Context Success in palliative care is not easily measured by quantifiable metrics. There are many reasons to account for medical activity. Doctors are an expensive resource, demonstrating workload can be challenging as doctors work within both medical and multi-disciplinary teams, across a number of care settings, and perform a range of diverse roles.

With colleagues in the South West, it became clear that a limited range of activity data is collected by medical teams. This quantitative data generally relates to direct patient contact and fails to contextualise complexity or duration of consultations. Data on activities such as education, provision of advice to other professionals, audit, service improvement, etc. are often not captured or reported on outside of appraisals.

Aim To collect data that:

  • Captures the totality of medical practice, and

  • Can be of use to the organisation, medical team and the individual doctors.

Method Utilising the experience of hospice nursing colleagues, a 'Time and Motion’ approach was adopted.

Categories chosen were based on Job Plans:

  • Clinical activity – this was broken down as to whether ‘direct’ or ‘consultative’; and by place

  • Continual Professional Development – Education recorded separately

  • Additional Duties e.g. Medical Director role

Outcome Following a successful four day pilot the entire medical team participated in recording activity for a one month period.

Results Will be presented.

Conclusion The rich data obtained has a number of uses. It:

  • Demonstrates the time the medical team spend clinically in the different care settings

  • Provides information for use in annual appraisals, job planning and team management

  • Contextualises activity to ensure focus and balance of effort

  • Assists the team in articulating the diversity of their roles

  • Enables future monitoring of changes in working practices

  • Potentially enables benchmarking with other similar services

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