Palliative Care Outcomes Collaboration

PCOC is a national palliative care program funded by the Australian Government Department of Health and Aged Care. It aims to improve patient outcomes and has enabled clinicians to achieve significant improvements in patient and carer outcomes over time.

PCOC's core framework and protocol for clinical assessment and response create a common clinical language, helping to identify and address needs effectively.

Participation is voluntary and open to any Australian health service providing palliative care.

About PCOC

The ultimate measure of quality is the outcomes that patients, their families and carers achieve. PCOC is a voluntary program that is improving the quality and outcomes in palliative care in Australia, and internationally.

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There are many ways we know we are providing good care. We can measure our processes and display our thank you letters. But how do we know we are improving patient care? Show we do what we say we do. We focus on patient outcomes. The Australian Palliative Care Outcomes Collaboration, or PCOC, is the only source of routine palliative care outcome data in Australia and provides the facts about the effect of palliative care. The ultimate measure of quality is the outcomes that our patients and their families and carers achieve.

PCOC is a national voluntary program that is improving the quality and outcomes of palliative care in Australia by producing information to be used by clinicians and by local state and national providers of palliative care, to continually improve care for patients and their families.

PCOC measures outcomes for pain, including physical symptoms, psychological and spiritual needs, as well as family and carer outcomes. This provides evidence to mojito and prove the outcomes of care and drive continuous improvement in palliative care.

How does PCOC work? Let’s look at the six-monthly PCOC cycle. First, clinicians use the assessment tools to assess and respond to each patient’s needs. Then, PCOC reports the assessment data back to you. Benchmarking takes place so you can compare results. Then, PCOC facilitates feedback methods that identify achievements and areas for change. Feedback is an essential part of improvement. And then you start the PCOC cycle again.

PCOC is the world’s largest national routine point-of-care data collection for quality improvement, representing more than 80 per cent of all palliative care patients referred to specialist services in Australia, or 40,000 people each year, measuring outcomes for people as they move between home and hospital.

Does PCOC work? National results show statistically significant improvements over time in all symptom domains and in key palliative care problem domains. PCOC embeds and sustains two key frameworks into routine procedure and practice; the PCOC assessment framework and the quality improvement and change framework. The benefits of the assessment framework include; standard assessment and a common language when planning care or handing over in any care setting, baseline assessment and snapshot of patient needs, the ability to track and respond to patient symptoms, patients and their families and carers are part of the decision making, and care is driven by need. The benefits of the quality improvement and change framework include providing a structure for; evidence for the care being provided, outcomes triggering a review of processes, identifying areas for targeted quality improvement, identifying priorities for clinical and systems management change, and service planning. PCOC also helps with meeting requirements for accreditation by providing evidence of participation in quality improvement, and assists with local, state and national research on patient outcomes.

By firmly embedding a culture of quality improvement through the PCOC program, your service can measure and improve the care it provides, resulting in a better patient and family and carer experience and improved outcomes of care.

COVID-19 data collection

In response to the COVID-19 pandemic, PCOC began the immediate small data collection on COVID-19 patients. As an interim solution to capture COVID-19 data, PCOC has developed a simple Excel spreadsheet. This manual system will be in place on an interim basis. It will be replaced by the next version of the PCOC dataset and software, at which time we will expand the diagnosis codes in our routine collection to create a separate code for COVID-19.

PCOC will ask services to submit the data collected in conjunction with the next 6-monthly data submission (commencing 1 July 2020). Contact us for further information.

Frequently asked questions

Palliative care is care in which the primary clinical purpose or treatment goal is to optimise of the quality of life of a patient or resident that has an active and advanced life-limiting illness. The patient (or resident) will have complex physical, psychosocial and/or spiritual needs. Palliative care is always:

  • Delivered under the management of or informed by a clinician with specialised expertise in palliative care, and
  • Evidenced by an individualised multidisciplinary assessment and management plan, which is documented in the patient's (or resident's) medical record. The plan must cover the physical, psychological, emotional, social and spiritual needs of the patient, as well as include negotiated goals (Independent Hospital Pricing Authority). 

Palliative care is different to end-of-life care.

End-of-life care is provided when a person likely to die within the next 12 months. The person may have an advanced, progressive, incurable condition, or general frailty and a co-existing condition, an existing condition with risk of dying from sudden acute crisis, or a life-threatening acute condition. End-of-life care includes an assessment of physical, spiritual and psychosocial needs, care and treatment, and support of families and carers.

(Australian Commission on Safety and Quality in Health Care; Australian Government Department of Health)

In PCOC, the terminal phase of care is defined as the period when the patient is likely to die in a matter of days. This is sometimes referred to as the period when a patient is actively dying. Terminal care can also be referred to as end-stage care. Terminal care may form part of end-of-life care and part of palliative care.

(Australian Commission on Safety and Quality in Health Care; Australian Government Department of Health)

Within Australia and internationally, not everyone who needs palliative care can access it. Due to the growing ageing population with complex needs, the demand for palliative care will soon outstrip most countries' ability to provide specialist palliative care. Understanding palliative care service provision in terms of service capability, rather than specialist versus generalist care, can help support the growth of palliative care. Service capability includes understanding models of care, the context in which care is provided, the linkages between services, and the skill mix and inputs available. Thinking about service capability helps integrate specialist and generalist palliative care because it highlights the links between different types of services, and this can help with service planning and commissioning. Understanding the capability of services can also help patients, their families and carers access the services that are best suited to meet their needs.

© 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 and Aged Care.