Article Text
Abstract
It is established that using Palliative Outcome Measures (POMs) leads to an improvement in health related quality of life. The hospital and hospice palliative care teams identified that different assessment tools were being used across both settings and recognised this was a barrier to communication. Working together using the same assessment tools would improve communication, ensure consistency and promote patient centred care.
Our aim was to implement POMs (Phase of Illness, Australia-modified Karnofsky Performance Status (AKPS) and Integrated Palliative Outcome Scale (IPOS) across both settings in order to provide a consistent approach.
Using the POMs we wanted to capture changes in health status, promote improved communication between professionals, aid decision making, ensure patient driven assessment and planning and monitor if IPOS scores show an improvement in patient symptoms, wellbeing and quality of life.
Joint meetings and training have already taken place with the plan to use quality improvement methodology to show whether:
POMs are being used between settings and effectively improve communication.
The level of patient compliance and whether it is user friendly
Early recognition of patient symptoms and wellbeing leads to prompt interventions
If patients admitted to hospital, hospice named nurse informs palliative care team of Phase of Illness and AKPS score.
On hospital discharge letter to hospice/GPs/District Nurses the Phase of Illness and AKPS score is recorded.
An IPOS form is given to all known and new hospice patients on discharge from WGH.
Hospice to use PCOMs at MDT, and IPU meeting and record on handover sheets and electronic patient system.
Using the QI methodology the first three PDSA cycles were formulated, Cycle 1& 2 being joint meetings and training and a Go Live date was set. Cycle 3 plans to undertake the first review and audit after three months, when further cycles will be planned.