Palliative care outpatients and improved documentation-what matters most? Quality improvement project
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作者:
Srilatha, Bharathi
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Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Srilatha, Bharathi
[1
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Sundararaj, Jenifer Jeba
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Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Sundararaj, Jenifer Jeba
[1
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Susithra, D. N.
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Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Susithra, D. N.
[1
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Prasoona, Thotampuri Shanthi
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Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Prasoona, Thotampuri Shanthi
[1
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Joseph, Jewell
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Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Joseph, Jewell
[1
]
Celine, Thangarathi
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Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Celine, Thangarathi
[1
]
Murali, Shakila
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Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Murali, Shakila
[1
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Joseph, Lallu
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Christian Med Coll & Hosp Vellore, Vellore, Tamil Nadu, IndiaChristian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
Joseph, Lallu
[2
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机构:
[1] Christian Med Coll & Hosp Vellore, Palliat Med, Vellore, Tamil Nadu, India
[2] Christian Med Coll & Hosp Vellore, Vellore, Tamil Nadu, India
Quality of life;
Clinical assessment;
Communication;
Supportive care;
PATIENT;
D O I:
10.1136/spcare-2023-004650
中图分类号:
R19 [保健组织与事业(卫生事业管理)];
学科分类号:
摘要:
ObjectivePatients needs should be regularly assessed. We aimed to improve assessment and documentation of needs from baseline 25% in June 2022 to 75% in December 2022.MethodsThe A3, a structured problem-solving continuous-improvement methodology was used. Fish-bone analysis and pareto charts identified root causes; key drivers and interventions were developed. Interventions included (1) documentation templates, (2) a brochure about services, (3) extra team communication skills training, (4) repository in different languages to help patients identify needs, and (5) weekly review meetings. Reliability and sustainability were ensured through ownership and delegation to team members.ResultsDocumentation of needs increased from baseline 25% to 75% within 3 months. This has been sustained at 83% in August 2023. The total number of patients assessed during the project was 1818. Maximum percentage of documentation was 91%. Mean additional time taken to ask and document needs was 2 min.ConclusionsIdentification and documentation of patient needs and prioritisation are feasible in palliative medicine outpatient clinics. This project has directed the team to provide patient-led palliative care interventions.
机构:
Univ Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
Univ Miami, Miller Sch Med, Holtz Childrens Hosp, Div Pediat Crit Care,Dept Pediat, 1611 NW 12th Ave, ET 6006, Miami, FL 33136 USAUniv Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
Alladin, Amanda
Khawand-Azoulai, Mariana
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Univ Miami, Miller Sch Med, Dept Med, Div Geriatr & Palliat Med, Miami, FL USAUniv Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
Khawand-Azoulai, Mariana
Lipman, Kyra
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Univ Miami, Miller Sch Med, Miami, FL USAUniv Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
Lipman, Kyra
Bland, Sarah
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Univ Miami, Miller Sch Med, Dept Med Educ, Miami, FL USAUniv Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
Bland, Sarah
Ferrari, Corinne
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Univ Miami, Miller Sch Med, Sylvester Comprehens Canc Ctr, Miami, FL USAUniv Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
Ferrari, Corinne
Drice, Jenny
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Univ Miami, Miller Sch Med, Dept Med Educ, Div Geriatr & Palliat Med, Miami, FL USAUniv Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
Drice, Jenny
Van Zuilen, Maria Hendrika
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Univ Miami, Miller Sch Med, Dept Med Educ, Miami, FL USAUniv Miami, Miller Sch Med, Dept Pediat, Div Pediat Crit Care, Miami, FL USA
机构:
Childrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
Farooki, Sana
Olaiya, Oluwaseun
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Childrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
Olaiya, Oluwaseun
Tarbell, Lisa
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Childrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
Tarbell, Lisa
Clark, Nicholas A.
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Childrens Mercy Hosp, Div Hosp Med, Dept Pediat, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
Clark, Nicholas A.
Linebarger, Jennifer S.
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Childrens Mercy Hosp, Dept Pediat, Sect Palliat Care, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
Linebarger, Jennifer S.
Stroh, John
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Childrens Mercy Hosp, Dept Pediat, Sect Palliat Care, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
Stroh, John
Ellis, Kelstan
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Childrens Mercy Hosp, Dept Pediat, Sect Palliat Care, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
Ellis, Kelstan
Lewing, Karen
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Childrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USAChildrens Mercy Hosp, Div Hematol Oncol, Dept Pediat, Kansas City, MO 64108 USA
机构:
H Lee Moffitt Canc Ctr & Res Inst, Nursing Profess Dev Dept, Tampa, FL USAH Lee Moffitt Canc Ctr & Res Inst, Nursing Profess Dev Dept, Tampa, FL USA
Vonnes, Cassandra
Parrish, Lauren
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H Lee Moffitt Canc Ctr & Res Inst, Blood & Marrow Transplant Treatment Ctr, Tampa, FL USAH Lee Moffitt Canc Ctr & Res Inst, Nursing Profess Dev Dept, Tampa, FL USA
Parrish, Lauren
El-Rady, Rosalie
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H Lee Moffitt Canc Ctr & Res Inst, Senior Adult Oncol Clin, Tampa, FL USAH Lee Moffitt Canc Ctr & Res Inst, Nursing Profess Dev Dept, Tampa, FL USA
El-Rady, Rosalie
Patterson, Dorothy
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H Lee Moffitt Canc Ctr & Res Inst, Breast Clin, Tampa, FL USAH Lee Moffitt Canc Ctr & Res Inst, Nursing Profess Dev Dept, Tampa, FL USA
Patterson, Dorothy
Mason, Tina M.
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H Lee Moffitt Canc Ctr & Res Inst, Dept Nursing Res, Tampa, FL USAH Lee Moffitt Canc Ctr & Res Inst, Nursing Profess Dev Dept, Tampa, FL USA
机构:
Childrens Hlth Childrens Med Ctr Dallas, Inpatient Pulmonol Unit, 1935 Med Dist Dr, Dallas, TX 75235 USAChildrens Hlth Childrens Med Ctr Dallas, Inpatient Pulmonol Unit, 1935 Med Dist Dr, Dallas, TX 75235 USA
Joyner, Michelle K.
Afolabi, Folashade C.
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Univ Texas Southwestern Med Ctr, Dallas, TX USAChildrens Hlth Childrens Med Ctr Dallas, Inpatient Pulmonol Unit, 1935 Med Dist Dr, Dallas, TX 75235 USA
Afolabi, Folashade C.
Payne, Tessa L.
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Childrens Hlth Childrens Med Ctr Plano, Pediat Intens Care Unit, Plano, TX USAChildrens Hlth Childrens Med Ctr Dallas, Inpatient Pulmonol Unit, 1935 Med Dist Dr, Dallas, TX 75235 USA
Payne, Tessa L.
Hueckel, Remi M.
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Duke Univ, Sch Nursing, Durham, NC USA
Duke Univ Hosp, Durham, NC USAChildrens Hlth Childrens Med Ctr Dallas, Inpatient Pulmonol Unit, 1935 Med Dist Dr, Dallas, TX 75235 USA