Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking

Purpose Every health care sector including hospice/palliative care needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients’ outcomes and the consistency o...

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Vydané v:Supportive care in cancer Ročník 23; číslo 2; s. 307 - 315
Hlavní autori: Currow, David C., Allingham, Samuel, Yates, Patsy, Johnson, Claire, Clark, Katherine, Eagar, Kathy
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2015
Springer
Springer Nature B.V
Predmet:
Adolescent
Adult
Aged
Aged, 80 and over
Australia
Benchmarking
Benchmarks
Cancer
Child
Child, Preschool
Clinical assessment
Clinical outcomes
Comparative analysis
Cooperative Behavior
Data Collection
Data entry
Feedback
Female
Health care reform
Health services
Hospice care
Hospice Care - psychology
Hospice Care - statistics & numerical data
Hospices - statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Medicine
Medicine & Public Health
Mental health services
Middle Aged
Neoplasms - psychology
Neoplasms - therapy
Nursing
Nursing Research
Oncology
Original
Original Article
Pain Medicine
Palliative care
Palliative Care - statistics & numerical data
Palliative treatment
Patient Outcome Assessment
Patients
Rehabilitation Medicine
Spirituality
Symptoms
Treatment outcomes
Young Adult
Australia
Palliative care
Clinical benchmarking
Performance measurement
Symptom control
ISSN:0941-4355, 1433-7339, 1433-7339
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Shrnutí:Purpose Every health care sector including hospice/palliative care needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients’ outcomes and the consistency of these outcomes have improved in the last 3 years. Methods Data were analysed by clinical phase (stable, unstable, deteriorating, terminal). Patient-level data included the Symptom Assessment Scale and the Palliative Care Problem Severity Score. Nationally collected point-of-care data were anchored for the period July–December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period ( n  = 30) using individual longitudinal multi-level random coefficient models. Results Data were analysed for 19,747 patients (46 % female; 85 % cancer; 27,928 episodes of care; 65,463 phases). There were significant improvements across all domains (symptom control, family care, psychological and spiritual care) except pain. Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved. Conclusion These are the first national hospice/palliative care symptom control performance data to demonstrate improvements in clinical outcomes at a service level as a result of routine data collection and systematic feedback.
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ISSN:0941-4355
1433-7339
1433-7339
DOI:10.1007/s00520-014-2351-8