welcome, new members! - pcqn · welcome, new members! may 12th, 2015 steven pantilat, md, faahpm,...
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Welcome, New Members!
May 12th, 2015
Steven Pantilat, MD, FAAHPM, MHM
Director, PCQN
Ashley Bragg
Deputy Director, PCQN
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PCQN Mission
To transform healthcare by defining and
promoting quality palliative care
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PC Field
Institution
PCS Team
Clinician
Patient
PCQN
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PCQN At a Glance
• Established in 2009 with grant funding
• 34 members and growing
– Diverse group of hospitals including
academic, community, system, public
• 20 submitting data
• Patient Encounters: 13,000+
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PCQN Components
• Database & reports
• In-person conferences
• Monthly conference calls
• CaseMaker PCS
• QI Collaborative
• PCQN website
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PCQN Dataset
• PCQN core dataset: 23 data elements
– Demographics: 8
– Operations: 5
– Processes: 3
– Clinical outcomes: 7
• Data dictionary
– Definitions, categories, measures
• Optional data elements: 22
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Data Collection
• PCQN members collect a core dataset
for each patient
– On paper
– Direct entry
– CSV file upload
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PCQN Database
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PCQN Database
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Data Collection Form
Copyright 2012, Palliative Care Quality Network (PCQN)
PCQN ID #:_________________________________
(1) Consult request date: ______/______/______
(2) Hospital admit date: ______/______/______ (same as consult date if admit avoided)
(3) Age: ___________ (4) Gender: __________
Medical record #: _______________________________________
Last name: ____________________________________________
First name: ____________________________________________
Encounter #/ Visit ID:_______________ DOB: ______/______/______
(5) Location at time of referral (choose one):
! Med/Surg
! Telemetry/Step Down
! Critical Care
! Ambulatory/Outpt clinic
! Emergency Department
! Pediatrics
! Labor & Delivery
! Acute Rehab
! SNF
! Other: ______________
(6) Reasons given by referring provider for initial PC consult (check all that apply):
! Goals of care discussion/Advance
Care Planning
! Pain management
! Other symptom management
! Withdrawal of interventions
! Transfer to comfort care bed/unit
! Comfort Care
! Hospice referral/discussion
! No reason given
! Support for patient/family
! Other:
_____________________________
(7) Primary diagnosis leading to PC consult (check one):
! Cancer (solid tumor)
! Cardiovascular
! Pulmonary
! Vascular
! Complex chronic
conditions/failure to thrive
! Renal
! Trauma
! Congenital/chromosomal
! Gastrointestinal
! Hepatic
! Hematology
! Infectious/
immunological/HIV
! In-utero
complication/condition
! Neurologic/stroke/
neurodegenerative
! Dementia
! Other_______________
(8) Code status at time of consult?
! Full ! Partial ! DNR/DNI
(9) Advance Directive document on chart at time of consult?
! Yes ! No
(10) POLST on chart at time of consult?
! Yes ! No
(18) ! Patient not seen (if patient not seen, do not record responses for data elements #11, 12, 13, 14, 15, 17)
Reason:__________________________________
(11) Family meeting: Circle number each time you have a meeting
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
(12) PC team member disciplines involved in the consultation: Assessment/Outcomes (check all that apply):
! Physician
! Clinical Nurse
Specialist
! Nurse Practitioner
! Physician Assistant
! Nurse
! Social Worker
! Chaplain
! Pharmacist
! Psychologist/
Psychiatrist
! Other
(13) Screened Positive
! Pain
! Non-pain symptoms
! Psychosocial issues
! Spiritual needs
! Goals of care/Adv.
care planning needs
(14) Intervened
! Pain
! Non-pain symptoms
! Psychosocial issues
! Spiritual issues
! Goals of care/Adv.
care planning
(15) Other
! Code status clarified
! Advance Directive
completed
! POLST completed
! Avoided Admission (17) Palliative Performance Scale (PPS) at time of consult (circle): (over for criteria)
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
(16) Discharge/Sign Off date:
________/________/________
(same as consult date if admit avoided)
If team signs off prior to D/C then dispo (#18) is
“hospital inpatient”
(18) Discharge disposition
Patient status at Discharge: ! Alive ! Dead
Location
! Home
! LTAC (long-term acute care hospital)
! ECF (Extended care facility)
! Hospital Inpatient
! Non-Hospital Inpatient/Inpatient Hospice
! Residential Care Facility/Assisted Living
! Respite/ Shelter/ SRO
! Other _________________________
Service
! Home Health
! Palliative Care: Clinic-Based
! Palliative Care: Home-Based
! Hospice
! No Services
! Other ____________________
(19 -23) Symptoms Patient report only: None: 0 Mild: 1 Moderate: 2 Severe: 3
Pt. seen but unable to rate: 9 Pt. seen but not assessed: 7
Date
Pain
Anxiety
Nausea/Vomiting
Dyspnea
Bowel Mvmt (Y/N)
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Database
• Secure, web-based database
• Each site owns its data
– Can download data at any time
• Encounter List
• Daily Rounding Tool
• Database Report
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Data Reports
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Reports
• Reports in real time with click of mouse
– Summary Reports
– Trend Reports
– Member Comparison Reports
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Get Involved
• Committees
– Data, Membership, QI, Dissemination
• Monthly conference calls – present!
• Quality Improvement Collaborative
– Monthly calls, ongoing mentorship
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PCQN:
A Magic Trip
If you want to go
fast, go alone.
If you want to go
far, go together.
African proverb