pcoc is a national palliative care project funded by the australian government department of health ...
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PCOC is a national palliative care project funded by the Australian Government Department of Health www.pcoc.org.au
Using PCOC to improve palliative care –
A Victorian success story
Sabina ClaphamEducation Manager
Key Outcome Results
Report on Trends in Victoria Periodic survey exploring how PCOC outcome
measures are used by services to improve quality
About PCOC
The Palliative Care Outcomes Collaboration (PCOC) aims to improve patient outcomes
through routine clinical outcome measurement, periodic surveys and benchmarking.
Demographics
Patient Information Collected
Setting of care
Episode
Assessments
Patient Information Collected
Patient contact in the hospital
consultative setting
g
Patient contact in the community
setting, by phone or in -person
On Admission
At change in plan of care
On Admission
A minimum of daily in the
inpatient setting
At discharge
Trends in Victoria
Over 100 services across Australia, including 20 Victorian services, participate in patient outcome reporting.
Contributing Services
Number of PCOC services and patients
Key results over time – unstable phases
Key results over time – unstable phases by setting
Key results over time – absent/mild pain
Key results over time – absent/mild pain by setting
Key results over time – moderate/severe pain
Key results over time – moderate/severe pain by setting
Patients whose change in pain and symptoms is the same as or better than the national average patient at baseline (2008)
Patients whose change in pain and symptoms is the same as or better than the national average patient at baseline (2008)
Place of Death
Place of death Number %
Hospital 1350 59.0
Private residence 506 22.1
Residential aged care setting 348 15.2
Not stated/inadequately described 83 3.6
Total 2287 100
Summary
Clinical assessments are used to
Prove Patient Outcomes
Improve Patient Outcomes
18
Quality im
prove
ment
NSAP se
lf-asse
ssment
Servi
ce planning
Accre
ditation
Workf
orce deve
lopment
Funding applic
ations
Internal o
rganisa
tion reporti
ng
Identifying educa
tion needs0
10
20
30
40
50
60
How services have used outcome measuresN
umbe
r of
res
pons
es
Time from referral to first contact Time in unstable phase Change in pain Change in symptoms relative to the national average
0
5
10
15
20
25
Quality improvement activities & outcome measuresN
umbe
r of r
espo
nses
Education re
garding cli
nical a
ssessm
ent tools
Using phase to
prioriti
se clinica
l disc
ussions
Tools to im
prove sy
mptom management
Triage to
ol / pro
cedure
Review of pro
cesse
s and sy
stem
Medical re
cord
audit
Development of p
erform
ance in
dicators
More frequent c
ontacts fo
r community
patients
Changes to fo
rms /
documentation
Implementation of e
nd of life ca
re pathway
Workforce
evaluation0
2
4
6
8
10
12
14
Quality improvement activitiesN
umbe
r of r
espo
nden
ts
0
2
4
6
8
10
12Outcomes of quality improvement activities
Num
ber
of r
espo
nses
Summary
A broad range of quality improvement activities have resulted from PCOC reporting
PCOC outcome measures show consistent improvement in palliative care over time
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A culture of quality improvement is firmly embedded in services participating in PCOC