Orientation to Palliative Care Assessments This PowerPoint presentation is part of a series of PowerPoint presentations from the PCOC Assessments Toolkit. It is designed for use in routine or regular education sessions. To undertake this learning activity please have copies of: PCOC assessment tools lanyard card available from your QIF or www.pcoc.org.au Your palliative care assessment form/s or the PCOC Sample assessment form located in the toolkit or available at: www.pcoc.org.au The PCOC Assessment Toolkit Education or clinical support staff may use this presentation and the other resources contained in the PCOC Assessment toolkit as part of a palliative care service’s ongoing education plan. This presentation may be used in conjunction with the 12 minute PCOC DVD; Understanding PCOC. Funded under the National Palliative Care Program and is supported by the Australian Government Department of Health and Ageing.

Standardising Palliative Care Assessment PCOC is a national approach towards the routine assessment in palliative care practice using standardised assessment tools. PCOC is the only national voluntary program utilising standardised validated clinical assessment tools to benchmark and measure outcomes in palliative care. PCOC assists palliative care providers to improve patient outcomes by enabling clinicians to accurately assess the quality of care. PCOC obtains and reports on information regarding patient care and symptom management please contact your QIF or go to the PCOC website to see a sample of a report www.pcoc.org.au

Assessment Tools (Fries et al, 1994) (Abernethy et al, 2005) Phase (Eagar et al, 2004¹) RUG-ADL (Fries et al, 1994) AKPS (Abernethy et al, 2005) The tools assess the key domains of palliative care. These are the phase of illness, the patient’s functioning and performance, pain and other common symptoms, the patient’s psycho/spiritual distress and family/carer distress associated with the patient’s illness. Phase describes the patient’s stage of illness RUG tells us about the patient and their dependency and the resources required, AKPS tells us about the patients performance and what they are actually able to do, PCPSS is an overall distress score of the patient and family. It is a clinician rated tool. SAS tells us about 7 specific symptoms and which of these are most troublesome. It is rated by the patient except for “proxy” situations. PCPSS (Eagar et al, 2004²) SAS (Kristjanson et al, 1999)

(phone or face-to-face assessment) Palliative Care Assessments The assessments are undertaken At contact in consultative or community settings (phone or face-to-face assessment) A minimum of daily in the inpatient setting At phase change The goal is to incorporate these assessment tools into routine practice and to use the assessments to guide care. It may be helpful to view assessments as palliative care observations The assessment results should trigger interventions such as pain management, referral to other disciplines. Assessments can be conducted over the phone as part of follow up, however, a face to face assessment must take place in order to open an episode

Benefits of Standard Assessments Assessments drive the focus of care Consistent, formal approach to documentation of assessments A common language is established There are many benefits of using the PCOC assessments in clinical practice. Use the above points to start discussion as well as more as listed below. These were identified by services who are currently using the assessments at the March 2010 Champions Workshop (pre-survey and post survey). These are also listed in the PCOC Assessments toolkit Improves symptom management Consistent, formal documentation of assessment Assessment guides the focus of care Provides a consistent clinical picture of the individual patient Acknowledges the carer/family as part of the unit of care Provides a common language to use in handover A seamless service between home, hospital and palliative care unit Enhances communication between patients, families and clinicians Assessment across domains provides referral triggers Complements NSAP, National Standards Assessment Program

Information collected for PCOC Demographics (patient items) PCOC assessments are one part of the information collected by services participating in PCOC. Collecting the information in each of the 3 levels is essential for an accurate description of patients using the palliative care service including how they enter and exit the service and for what reasons. There are 2 sample forms available to collect this information. One for level 1 and 2 items and one for clinical assessments. You can find these forms in the PCOC Assessment toolkit or at www.pcoc.org.au Patient is the demographic information. It is collected as part of the administrative processes in the admission of a patient Episode is determined by location and is information about the type of service and the way a person enters and exits this episode. This enables PCOC to report information about how a person uses a palliative care service. Essentially, this information will enable descriptions of palliative care services across Australia and what they provide, for example consultative services within acute hospitals, community services, stand-alone inpatient units. Phase is about the clinical condition of patient and family. To capture this, 5 assessment tools are used. This information will enable services to describe their patient’s clinical condition and their response to care and interventions. Setting of care (episode items) Assessments (phase items)

Thank You For further information please view the resources contained in the PCOC Assessment Toolkit, go to or contact your Quality Improvement Facilitator Please view the other 3 PCOC video presentations and the PCOC DVD, Understanding PCOC. These resources are located in the PCOC Assessment Toolkit or on the PCOC website. Funded under the National Palliative Care Program and is supported by the Australian Government Department of Health and Ageing