Dr Claudia Virdun1,2,3,4, Dr Elise Button3, Professor Jane Phillips3,4, Assistant Professor Catherine Saunders5, Distinguished Professor Patsy Yates3, Associate Professor Tim Luckett4
1College of Nursing and Health Sciences, Flinders University, Adelaide, Australia, 2Flinders Research Centre for Palliative Care, Death, and Dying, Adelaide, Australia, 3Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia, 4Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Sydney, Australia, 5Dartmouth Health and The Geisel School of Medicine at Dartmouth, Lebanon, United States of America
Biography:
Dr Claudia Virdun is an experienced specialist palliative care nurse interested in enabling optimal care for people with advanced serious illness. Claudia’s passion for excellence in palliative care has seen her focus on clinical care delivery, research and improvement work to inform service change. Claudia is currently a Senior Lecturer in Palliative & End of Life Care for Flinders University.
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 but how to achieve this remains elusive. Patient-reported experience measures (PREMs) may assist in improvement work.
Aim: To determine the feasibility of implementing a brief patient-reported experience measure consideRATE within the Australian hospital inpatient setting, and appraise its acceptability as perceived by inpatients with palliative care needs, their carers and clinicians.
Methods: A prospective study using: 1) PREM administration with patients and carers; and 2) a focus group with clinicians on the usefulness of PREMs to inform improvement. Eligible participants were recruited from three wards in two departments (cancer care and internal medicine) of an Australian tertiary metropolitan hospital.
Results: Feasibility: A 71% response rate was achieved (n=80 from 112 eligible patients). Mean screening time from the ward handover sheet was 7.5 minutes (range 2-12 mins). More than half (n=47, 59%) opted for electronic completion. Mean completion time was 6.12 minutes (range 44 seconds – 17.49 minutes, median = 5.14 mins). A third of participants required assistance for PREM completion (n=27, 34%). Score distribution varied across response options, albeit with a positive skew towards ‘very good’ and ‘good’. A third of respondents (n= 50, 62.5%) provided ≥1 free-text response. Acceptability: Clinicians valued consideRATE data noting the need for it to be: accessible, supported by free-text and responsive to local contexts.
Conclusions: It is feasible to implement consideRATE for inpatients with palliative care needs. The high response rate indicates this patient population is willing and able to provide feedback about care quality. Supporting their participation is important given levels of illness and disability. Clinicians note consideRATE data is acceptable in informing improvement foci. Additional validation of consideRATE is warranted and forthcoming.