Dr Gursharan Singh1,2, Professor Alison Mudge3,4, Mrs Robyn Matthews5, Distinguished Professor Patsy Yates1,2, Professor Jane Phillips1,2, Dr Claudia Virdun1,2,6,7
1Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia, 2Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Australia, 3The University of Queensland, Greater Brisbane Medical School, Herston, Brisbane, Australia, 4Department of Internal Medicine, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Brisbane, Australia, 5Cancer Care Services, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Brisbane, Australia, 6Research Centre for Palliative Care, Death, and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia, 7Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney (UTS), Ultimo, Sydney, Australia
Biography:
Dr Gursharan Singh BMedSc(Hons), PhD is a Research Fellow in Palliative Care within the Cancer and Palliative Care Outcomes Centre at the School of Nursing, Queensland University of Technology (QUT). Gursharan's research interests include optimising palliative care delivery, heart failure, models of care and using linked administrative data in her research.
Abstract:
Background: Many patients with palliative care needs require care in the hospital setting. The need to enable improvement in palliative care provision in the hospital context is well noted. Patient-reported experience measures (PREMs) can assist in identifying areas for focused improvement.
Aim: To synthesise patient reported experience of care data from inpatients with palliative care needs to inform improvement.
Design: Cross-sectional study where patients with palliative care needs were invited to complete ‘consideRATE,’ a brief, validated patient reported experience measure designed to measure perceived quality of care for inpatients with serious illness. Descriptive statistics were used to analyse quantitative ratings whilst free text responses were analysed using integrated thematic analysis.
Setting/Participants: Patients with palliative care needs admitted to three wards (cancer care and internal medicine) at an Australian tertiary metropolitan hospital were screened for eligibility. Carers could provide proxy responses where patients were unable to participate.
Results: One-hundred and twenty participants (108 patients and 12 carers) completed consideRATE. The questions with the highest number of ‘very good’ responses were attention to symptoms, attention to feelings and attention to what matters most; the question with the lowest number of ‘very good’ responses was attention to patients’ affairs. Almost half (n=57, 48%) indicated that advance care planning ‘did not apply’ to their inpatient stay. Four themes that impacted on quality of care experienced, derived from 532 free text responses across 8 questions, emerged: 1) Feeling supported, 2) Feeling informed, 3) Feeling heard and 4) Navigating the clinical environment.
Conclusion: Enabling inpatients with palliative care needs to provide direct feedback about their experience of care quality is one method of ensuring improvements matter to patients. Understanding how to support clinical teams to use such data to make sustainable improvements is an important next step.