Palliative care service provision within Brisbane South: A prospective audit

The number of patients within the QEII Hospital Health Service District requiring palliative care is rising due to acceptance of supportive palliative care for a range of chronic conditions and because of the increasing incidence of cancer in our ageing population. Anecdotal reports have suggested that it is difficult to meet existing, let alone projected, palliative care service requirements in this area. The Brisbane South Palliative Care Collaborative (BSPCC) designed an audit and mapping study to describe current palliative service capacity, client profiles. and outcomes. Such information can inform the design and delivery of future services.

The 2-month, prospective snapshot audit included all new palliative admissions across in-patient and community-based sites, hospital readmissions and hospital out-patient episodes of care for patients referred to any of the six government and non-government service providers covering the catchment area. An episode of care was defined as the period between the admission and discharge of a patient from any service. Information collected included patient demographics such as age, sex, Indigenous status, dominant language and primary diagnosis. Referral patterns including referral source and reason for referral were documented. Service provision characteristics such as initial service provider, numbers of contacts with service providers and lengths of stay were collected. Outcomes of episodes of care such as place of death, transfer to hospice or discharges out of the audit area were also documented. In addition, the study involved other components including mapping of service characteristics and staffing levels against Palliative Care Australia standards, focus groups of staff and bereaved lay-carers and interviews with palliative care patients to explore their satisfaction with current service provision. Ethics approval involved five different committees.

This paper will present some of the process and operational issues associated with the collection of the data and some of the findings.