Is Inpatient Hospice Care Clinically Effective? Using Phase of Illness to Evaluate Care Outcomes for Patients Admitted to a Specialist Palliative Care Unit in Ireland.

Lucey, M; O'Reilly, M; Currow, D; Eagar, K; Walsh, D; Conroy, M; Twomey, F; O'Reilly, V; Doherty, M; Coffey, S; Sheridan, J; Moran, S

Is Inpatient Hospice Care Clinically Effective? Using Phase of Illness to Evaluate Care Outcomes for Patients Admitted to a Specialist Palliative Care Unit in Ireland.

Lucey, M O'Reilly, M Currow, D

Eagar, K Walsh, D Conroy, M Twomey, F O'Reilly, V Doherty, M Coffey, S Sheridan, J Moran, S

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Publisher:: MARY ANN LIEBERT, INC
Publication Type:: Journal Article
Citation:: Journal of palliative medicine, 2020, 23, (4), pp. 535-541
Issue Date:: 2020

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Field	Value	Language
dc.contributor.author	Lucey, M
dc.contributor.author	O'Reilly, M
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.contributor.author	Eagar, K
dc.contributor.author	Walsh, D
dc.contributor.author	Conroy, M
dc.contributor.author	Twomey, F
dc.contributor.author	O'Reilly, V
dc.contributor.author	Doherty, M
dc.contributor.author	Coffey, S
dc.contributor.author	Sheridan, J
dc.contributor.author	Moran, S
dc.date.accessioned	2020-08-20T02:00:45Z
dc.date.available	2020-08-20T02:00:45Z
dc.date.issued	2020
dc.identifier.citation	Journal of palliative medicine, 2020, 23, (4), pp. 535-541
dc.identifier.issn	1096-6218
dc.identifier.issn	1557-7740
dc.identifier.uri	http://hdl.handle.net/10453/142249
dc.description.abstract	Background: In health care, clinical effectiveness involves evaluating the degree to which clinical interventions achieve beneficial patient and caregiver outcomes. Objective: To evaluate the clinical effectiveness of care in a specialist palliative care unit (SPCU) in Ireland, including an analysis of the temporal relationship among admission, Phase of Illness and patient and family distress. Design/Measurements: A consecutive case series with prospectively collected admission data (n = 400). Using a casemix tool (Phase of Illness), pain, other symptoms, psychological and family distress, and performance status were documented on admission and then daily by medical staff. Results: Three hundred forty-two (85%) patients had complete data recorded on day 1. After admission, there were linear correlations between days since admission and progressive improvements in pain (Cramer's V = 0.131, p < 0.001), other symptoms (V = 0.206, p < 0.001), psychological distress (V = 0.101, p < 0.001), and family distress (V = 0.124, p < 0.001). Forty-three percent were in an unstable phase on admission. Nearly two thirds (60.7%) of these unstable patients converted to a stable phase within 48 hours of admission. Over the first 72 hours, 70.7% of unstable patients converted to a stable phase. There was also a significant correlation between phase stabilization and pain and symptom control (p = 0.007). Stable phase over the first 4 days and first 14 days was associated with significantly higher performance status. Conclusion: This study demonstrates the significant clinical effectiveness of SPCU admission across the different aspects of patient and family care.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	MARY ANN LIEBERT, INC
dc.relation.ispartof	Journal of palliative medicine
dc.relation.isbasedon	10.1089/jpm.2019.0295
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Gerontology
dc.title	Is Inpatient Hospice Care Clinically Effective? Using Phase of Illness to Evaluate Care Outcomes for Patients Admitted to a Specialist Palliative Care Unit in Ireland.
dc.type	Journal Article
utslib.citation.volume	23
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2020-08-20T02:00:41Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	23
utslib.citation.issue	4

Abstract:

Background: In health care, clinical effectiveness involves evaluating the degree to which clinical interventions achieve beneficial patient and caregiver outcomes. Objective: To evaluate the clinical effectiveness of care in a specialist palliative care unit (SPCU) in Ireland, including an analysis of the temporal relationship among admission, Phase of Illness and patient and family distress. Design/Measurements: A consecutive case series with prospectively collected admission data (n = 400). Using a casemix tool (Phase of Illness), pain, other symptoms, psychological and family distress, and performance status were documented on admission and then daily by medical staff. Results: Three hundred forty-two (85%) patients had complete data recorded on day 1. After admission, there were linear correlations between days since admission and progressive improvements in pain (Cramer's V = 0.131, p < 0.001), other symptoms (V = 0.206, p < 0.001), psychological distress (V = 0.101, p < 0.001), and family distress (V = 0.124, p < 0.001). Forty-three percent were in an unstable phase on admission. Nearly two thirds (60.7%) of these unstable patients converted to a stable phase within 48 hours of admission. Over the first 72 hours, 70.7% of unstable patients converted to a stable phase. There was also a significant correlation between phase stabilization and pain and symptom control (p = 0.007). Stable phase over the first 4 days and first 14 days was associated with significantly higher performance status. Conclusion: This study demonstrates the significant clinical effectiveness of SPCU admission across the different aspects of patient and family care.

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http://hdl.handle.net/10453/142249