National Palliative Care Registry : Hospital Palliative Care Preview

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1 National Palliative Care Registry : Hospital Palliative Care Preview Maggie Rogers, MPH Senior Research Associate, CAPC Tamara Dumanovsky, PhD VP Research & Analytics, CAPC September 15, 2016

2 The National Palliative Care Registry is a joint project of

3 The Registry is a central resource for comparative data, reporting, metrics and recent research on the composition and operations of palliative care programs.

4 The Registry serves palliative care programs across service delivery sites and is free and open to all.

5 National Participation 25% of All Hospital Palliative Care Programs (40% of programs at large hospitals)

6 Key Findings for Hospital Programs

7 6.0 Palliative Care Service Penetration Mean Median

8 Staffing Levels (means) 10.0 Head Count Full-time Equivalent

9 The Joint Commission Staffing Recommendations % of programs reporting a full core interdisciplinary palliative care team including: 30% 31% 38% 37% 42% 41% 44% Physician Nurse (APRN or RN) Social Worker Chaplain

10 Time from Hospital Admission to Palliative Care Consult (days) Mean Median Discharged Live % of programs report a mean time to consult of 3 days or less Deceased % of programs report a mean time to consult of 3 days or less

11 Time from Hospital Palliative Care Consult to Discharge (days) Mean Median Discharged Live % of programs report a mean time to discharge of 4 days or less Deceased

12 Key Findings for Hospital Programs 2015

13 Programs Reporting Each Discipline as Part of Their Team (%), 2015 APRN Physician SW 56.9 RN 42.2 Support Chaplain Administrator 29.2 Med Director Fellow Funded Volunteer In-kind PA 5.0 Pharmacist

14 Integration with ICU and Emergency Departments % of Programs reporting... ICU ED No formal coordination Work collaboratively ICU/ED has plans in place for palliative care

15 Palliative Care and Hospice Integration % of Programs reporting... One administrative entity 12.7 Administratively separate 35.0 Contracts in place 31.9 Informally collaborate 39.1

16 Average Length of Stay (days) Discharged Alive (80%), 2015 Time to Consult Consult to Discharge 500+ Beds Beds Beds <150 Beds

17 Average Length of Stay (days) Died in Hospital (20%), 2015 Time to Consult Consult to Discharge 500+ Beds Beds Beds <150 Beds

18 Discharge Location, Other Hospice 40.0 SNF Home 0.0 <150 Beds Beds Beds 500+ Beds

19 Percent Readmitted within 30 days 20.0 Mean Median <150 Beds Beds Beds 500+ Beds

20 Screening for Pain and Dyspnea (means), 2015 Pain Dyspnea Percent of patients screened If screened, percent that screened positive If positive, percent with clinical assessment / treatment in 24 hrs If positive, percent with improvement in 48 hrs

21 Referring Hospital Units (top five by %), Med/Surg ICU Oncology Emergency Telemetry/Step-down <150 Beds Beds Beds 500+ Beds 8

22 Referring Specialist (top five by %), Hospitalist Oncologist Internal Medicine Pulmonary/Critical Care Cardiologist <150 Beds Beds Beds 500+ Beds 8

23 Patient and Family Satisfaction Surveys, 2015 % of programs that report measuring patient/family satisfaction 38.1 % using a standard instrument 77.1 Average response rate 19.7

24 Registry Redesign More accessible and easier to use Enter, edit or update data at any time Expansion to all care settings

25 New Features Instant tables, graphs and comparative reports Graphs and tables that track your program over time More reports that compare your program to similar programs

26 New Features Invite a colleague feature to streamline sign-up and access for all team members Interactive dashboard for easy access to all surveys, reports and program information

27 Metrics & Resources Key definitions and calculations for Registry metrics Important data points from published research for easy reference Comprehensive summary reports on Registry data

28 National Palliative Care Registry Resources and Publications You can find summary data and relevant literature reviews at registry.capc.org Health Affairs Sept Spetz J, Dudley N, Trupin L, Rogers M, Meier DE, Dumanovsky T. Few Hospital Palliative Care Programs Meet National Staffing Recommendations Coming soon to registry.capc.org The Latest Trends and Insights in Hospital Palliative Care

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