Aim To develop a model of Palliative Care Outpatients that allows the patient access to appropriate professionals for their needs in a single visit.

Background There is good evidence that optimal palliative care of patients and their families is delivered through multidisciplinary teams. In 2015, to offer a more flexible and efficient service to our patients, we set up parallel medical and nursing outpatient clinics at the hospice. Our experience in running the outpatients and the identification of a need for therapy input led us to see the value of multidisciplinary consultations. We gained a place on our Trust’s ‘Team QI Fellowship Programme’ which gave us a valuable framework for this new development.

Project design Adoption of the PDSA cycle (Plan, Do, Study, Act) model. Creation of a Driver Diagram to establish our overall goal and the steps we needed to complete to achieve the goal. Process mapping of current outpatient service. Development of a patient questionnaire. Feedback from staff delivering outpatients.

Findings

• Administration process lacked efficiency

• Admin team required further training

• Identified that additional admin resource needed to deliver the service efficiently

• Outpatient environment felt isolated

• Feedback from patients: outpatients is an acceptable and helpful environment for accessing specialist palliative care.

Actions Consultation with staff and volunteers to make changes to allow the MDT clinic to run alongside Drop-In service, creating a more welcoming environment for patients and carers. Accessed training for the admin team on the booking system and streamlined booking processes. Development of a business case for additional admin resource for outpatients.

Outcome We launched our new MDT clinic in February 2018.

Results To date we have found our MDT clinic to be an effective way of delivering outpatient assessments.

Conclusion The patients have received a more holistic service in a single visit.