title: Impact of a Palliative Care Checklist on Clinical Documentation.
abstract: OBJECTIVE
  Checklists are used in many different settings for the purpose of standardization and reduction of preventable errors in practice. Our group sought to determine whether a palliative care checklist (PCC) would improve the clinical documentation of key patient information.
  
  
  METHODS
  An initial review of 110 randomly selected medical records dictated by 10 physicians was performed. The authors identified portions of the dictated medical records that were included regularly, as well as those that were frequently missed. A PCC was drafted after final approval was obtained from the 13 faculty members. Dictations from 13 clinical faculties in the supportive care center were reviewed. A χ(2) test or Fisher's exact test was applied to assess the difference in overall checked rates before and after checklist use. A paired t test was used to examine the difference in the average complete rate and checked rates before and after checklist use.
  
  
  RESULTS
  There were improvements in the documentation before and after the checklist for scores on the Cut-down, Annoyed, Guilty, Eye-opener questionnaire for alcoholism (79% v 94%; P ≤ .0001), psychosocial history (69% v 95%; P ≤ .0001), Eastern Cooperative Oncology Group performance status (38% v 81%; P ≤ .0001), advance care planning (28% v 41%; P = .0008), and overall (78% v 95%; P ≤ .0001). There was no significant improvement in the documentation for opioid-induced neurotoxicity (37% v 37%; P = .9492) or the Edmonton Symptom Assessment Scale (98% v 99%; P = .4511).
  
  
  CONCLUSIONS
  Our study showed that the use of a PCC improved the quality of the documentation of a patient visit in an outpatient clinical setting.
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA mdelacruz@mdanderson.org.
authors.forename: Maxine
authors.initials: M
authors.lastname: de la Cruz
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Akhila
authors.initials: A
authors.lastname: Reddy
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Marieberta
authors.initials: M
authors.lastname: Vidal
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Kimberson
authors.initials: K
authors.lastname: Tanco
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Ahsan
authors.initials: A
authors.lastname: Azhar
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Julio
authors.initials: J
authors.lastname: Silvestre
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Diane D
authors.initials: DD
authors.lastname: Liu
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Jimin
authors.initials: J
authors.lastname: Wu
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX and University of Virginia Health System, Charlottesville, VA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D002173:Cancer Care Facilities; D057189:Checklist; D019468:Disease Management; D004282:Documentation; D006801:Humans; D008499:Medical Records / Q000592:standards; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy; D010166:Palliative Care / Q000592:standards; D011795:Surveys and Questionnaires