Authors
  • David Currow1,
  • Sam Allingham2,
  • Patsy Yates3,
  • Claire Johnson4,
  • Katherine Clark5,
  • Kathy M Eagar2
Organisations
  • Flinders University1,
  • University of Wollongong2,
  • Queensland University of Technology (QUT)3,
  • University of Western Australia (UWA)4,
  • Calvary Mater Newcastle5
Year

2014

Excerpt
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 three years.

Data  were  analysed  by  clinical  phase  (stable,  unstable, deteriorating, termin I). 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 six-monthly reporting cycles for all services that submitted data in every time period (n=30) using individual longitudinal multi-level random coefficient models.

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 inter-quartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved.

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.