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Palliative Care Outcomes Collaboration

Primary care

In Australia each year, about 100,000 people die from a death that is predictable. Predicting these deaths can help improve access to palliative care. This can help ensure good palliative care outcomes in patients, and their families and carers, many of whom will continue to require input from primary care until the day that they die. Also bereaved families may require ongoing involvement in primary care after the death of their loved one.

PCOC’s outcomes and profile collection have been integrated into services that provide palliative care within primary care settings. PCOC’s profile program gives primary care providers a way to identify patients that may benefit from palliative care. It involves the completion of a one-off assessment.

Profile program form

Download the profile program form (pdf)

PCOC’s profile program helps identify those that may benefit from palliative care. This is done through a one-off assessment. This program helps identify and examine the characteristics of those that may need palliative care.

PCOC provides free education to help with this. Free software to help manage your data, and access to a network of palliative care providers through the PCOC collaboration.

The brief form allows you to capture, analyse and use referral and demographic information. The information captured is used to produce a profile report for your service. PCOC provides assistance to services to use these reports.

In addition to standard questions regarding demographics, PCOC’s five tools are embedded within the form. 

PCOC assessment tools

PCOC’s model relies on the use of five tools. These five tools help assess the characteristics and needs of patients. All of the tools are validated. They perform well in terms of their measurement properties. They perform well within the clinical settings. They are easy to use as part of routine care. Each tool has been used with hundreds of thousands of patients over the last decade.

 

  1. Palliative Care Phase
  2. Symptom Assessment Scale (SAS)
  3. Palliative Care Problem Severity Scale (PCPSS)
  4. Australia-modified Karnofsky Performance Status (AKPS) Scale
  5. Resource Utilisation Group - Activities of Daily Living (RUG-ADL)

What is the Palliative Care Phase?

The palliative care phase identifies a clinically meaningful period in a patient’s condition. The palliative care phase is determined by a holistic clinical assessment, which considers the needs of the patients and their family and carers. A change in palliative care phase represents a change in the person’s clinical condition and/or a change in the patient’s carers or family. These changes lead to a change in the patient’s care plan. Five palliative care phases (pdf) are possible. A patient may move back and forth between phases. A structured phase algorithm (pdf) can help guide healthcare professionals to determine the correct phase. Palliative care phase has a long history of development (pdf). Its development commenced in the 1990s. The palliative care community has described phase as an important tool. This is because it can help develop a common palliative care language across countries. Phase is used in Australia, Germany, Great Britain, Ireland, Taiwan and Singapore.

 

Key resources:

The PCOC Symptom Assessment Scale (SAS) is a patient-rated tool to measure the amount of distress caused by seven of the most common symptoms in palliative care. Staff need to know how bothered, worried or distressed patients are by each of the symptoms in order to effectively manage what matters to patients. The measure is easy to use and brief. Staff ask patients to rate their distress relating to each of the seven symptoms on a scale from 0 to 10, 0 being distress-free and 10 being severe distress.

 

Key resources:

 Translated SAS form:

The PCPSS is completed by clinicians. PCPSS measures the severity of symptoms. The tool can be used for initial screening, symptom management and ongoing coordination of palliative care. Four palliative care domains are assessed through PCPSS: pain, psychological/spiritual, other symptoms and family/carer. Each domain is rated on a four-point scale with 0=absent, 1 =mild, 2 =moderate and 3 =severe.

Key resources:

The RUG-ADL is a four-item scale. RUG-ADL measures functional status. It measures motor function in relation to activities of daily living (ADL). Four ADLs are examined: bed mobility, toileting, transfers and eating. RUG-ADL helps identify the assistance a patient needs to carry out these ADLs. RUG-ADL helps identify the resources that the patient needs. When assessments are completed, the assessment is based on what the person does, not what they are capable of doing.

Functional status is different to performance in that functional measures examine what the person does, not how they perform. Compared to other tools that measure function, the RUG-ADL is a measure particularly useful in palliative care. This is because ADLs are hierarchical. The RUG-ADL items (e.g. toileting, transfer) are the four items that a patient will lose last as they deteriorate and approach death.

 

Key resources:

The AKPS scale is a measure of the patient’s performance across the dimensions of activity, work and self-care. The AKPS results in a single score between 0 and 100. For PCOC, the scores from 10 through to 100 are reported. AKPS is completed by a clinician. It is based on observations of a patient’s ability to perform common tasks relating to activity, work and self-care.

 

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© PCOC UOW 2020. The intellectual property associated with a suite of resources on this website is owned by the Palliative Care Outcomes Collaboration (PCOC), University of Wollongong. PCOC has placed resources in the public domain and is happy for others to use them without charge, modification or development. These resources cannot be modified or developed without the consent of the University.

PCOC is a national palliative care project funded by the Australian Government Department of Health.