title: Implementing a patient-centred outcome measure in daily routine in a specialist palliative care inpatient hospital unit: An observational study.
abstract: Gathering clinical evidence data on patients' palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread.
  
  
  
  To implement a patient-centred outcome measure in daily practice and fulfil one quality indicator: improve pain during the 72 h after admission, in at least 75% of patients.
  
  
  
  An observational prospective study. The Palliative care Outcome Scale was used at admission (T0), third day (T1) and weekly.
  
  
  
  Hospital palliative care unit with 17 individual rooms. All patients admitted to the unit were included in the study.
  
  
  
  Preliminary results ( N = 84) revealed inconsistent and missing data (14%). Symptoms were sub-optimally controlled by T1. Processes changed, and only a team member could apply Palliative care Outcome Scale. Doctors were encouraged to grasp the meaning of Palliative care Outcome Scale results for each patient. The post-pilot included 317 patients. No missing data occurred. There was an improvement in most items between T0 and T1: 'pain' and 'other symptoms' presented statistical significant differences ( p < 0.05).
  
  
  
  Implementing a patient-centred outcome measure in a hospital palliative care service is feasible and improves quality of care. Controlling high pain at T0 improved (>80%) by T1. Results became more consistent and symptom control was improved overall. Patients are evaluated based on holistic domains by an interdisciplinary team and we have added a much needed measure to help guide improvement of the quality of care provided.
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Alze Pereira Dos Santos
authors.initials: AP
authors.lastname: Tavares
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Carolina
authors.initials: C
authors.lastname: Paparelli
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Carolina Sassaki
authors.initials: CS
authors.lastname: Kishimoto
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Silvia Avo
authors.initials: SA
authors.lastname: Cortizo
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Karen
authors.initials: K
authors.lastname: Ebina
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Mariana Sarkis
authors.initials: MS
authors.lastname: Braz
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Sandra Regina Gonçalves
authors.initials: SR
authors.lastname: Mazutti
authors.affiliation: 1 Hospital Paulistano, Sao Paulo, Brazil.
authors.forename: Marcio José Cristiano
authors.initials: MJ
authors.lastname: Arruda
authors.affiliation: 2 Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal.|3 Centro de Estudos e Investigação em Saúde da Universidade de Coimbra, Portugal.|4 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, United Kingdom.
authors.forename: Bárbara
authors.initials: B
authors.lastname: Antunes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011787:Quality of Health Care / Q000706:statistics & numerical data*
keywords: Palliative care; clinical practice; implementation; outcome assessment; palliative care daily routine; patient-centred outcome measures; quality improvement