Triaging the Terminally Ill—Development of the Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool

Russell, Bethany; Vogrin, Sara; Philip, Jennifer; Hennessy-Anderson, Nicole; Collins, Anna; Burchell, Jodie; Le, Brian; Brand, Caroline; Hudson, Peter; Sundararajan, Vijaya

doi:10.1016/j.jpainsymman.2019.08.009

Cited by 5 publications

(5 citation statements)

References 47 publications

(6 reference statements)

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“…It is encouraging to know that palliative care services make the experience of patients and families considerably better in most aspects of care and also that the palliative approach to care provided by general services can be effective [ 26 ]. However, the issue remains that palliative care services select patients on the basis of the services’ capacity to respond to physical symptoms most commonly found in advanced cancer patients [ 27 ], not the broader spectrum of end-of-life need found across the general population [ 14 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Winners and Losers in Palliative Care Service Delivery: Time for a Public Health Approach to Palliative and End of Life Care

et al. 2021

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Background: Consumer experience of palliative care has been inconsistently and selectively investigated. Methods: People in Western Australia who had experienced a life limiting illness in the past five years were recruited via social media and care organisations (2020) and invited to complete a cross sectional consumer survey on their experiences of the care they received. Results: 353 bereaved carers, current carers and patients responded. The winners, those who received the best quality end-of-life care, were those who were aware of palliative care as an end-of-life care (EOLC) option, qualified for admission to and were able to access a specialist palliative care program, and with mainly a cancer diagnosis. The losers, those who received end-of-life care that was adequate rather than best practice, were those who were unaware of palliative care as an EOLC option or did not qualify for or were unable to access specialist palliative care and had mainly a non-cancer diagnosis. Both groups were well supported throughout their illness by family and a wider social network. However, their family carers were not adequately supported by health services during caregiving and bereavement. Conclusions: A public health approach to palliative and end of life care is proposed to integrate tertiary, primary, and community services through active consumer engagement in the design and delivery of care. Therefore, suggested strategies may also have relevance in many other international settings.

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Section: Discussionmentioning

confidence: 99%

Winners and Losers in Palliative Care Service Delivery: Time for a Public Health Approach to Palliative and End of Life Care

et al. 2021

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“…This study builds on existing international evidence relating to the key elements of effective triage in palliative care-identifying physical suffering, imminent dying, psychological suffering and caregiver distress as key drivers of urgency. [13][14][15] These parameters are captured in the PCOC tool-PSS focuses on physical, psychological and caregiver distress, whereas terminal phase indicates proximity to death. Our study also showed that declining functional status can be added to the drivers of urgency of referral.…”

Section: Discussionmentioning

confidence: 99%

Using a validated case mix tool for use in the telephone-assisted triage of patients in a specialist palliative care community setting: a consecutive case series

Hough¹,

Lucey²,

O'Reilly³

et al. 2023

BMJ Support Palliat Care

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ObjectivesAllocating resources in palliative care is challenging due to the nature of life-limiting illness coupled with the propensity for significant physical symptoms and psychological distress. At present, there is no established system for triaging referrals and prioritising resource allocation.This study aimed to evaluate the feasibility of using a case mix assessment tool for telephone-assisted triaging of referrals to a specialist palliative care service. This assessed a patient’s phase of illness, Problem Severity Score (PSS) for complexity of symptom burden and psychological distress, and functional status.MethodsUsing a prospective consecutive case series approach, 450 referrals to community palliative care over a 6-month period were assessed. Scores for phase of illness, PSS and functional status were assessed at triage, as was the triage category of urgency of response.ResultsAnalysis demonstrated that phase of illness corresponds with triage category, with terminal or unstable phase patients significantly associated with urgent (category 1) referrals and highest priority for review. Decreased functional status and high PSS were useful predictors for increased urgency of referral.ConclusionsThese results demonstrate that this case mix tool could assist in the telephone assessment and triage of referrals to community palliative care.

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“…The relative influence of each of these factors on clinicians’ decision-making and thus their contribution to the tool’s scoring system was determined using an international discrete choice experiment. 10,11 Physical suffering was the most influential factor, assigned more than double the score of any other factor. Imminent dying, psychological suffering and caregiver distress also scored highly.…”

Section: Introductionmentioning

confidence: 99%

Validation of the responding to urgency of need in palliative care (RUN-PC) triage tool

et al. 2021

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Background: The Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool is a novel, evidence-based tool by which specialist palliative care services can manage waiting lists and workflow by prioritising access to care for those patients with the most pressing needs in an equitable, efficient and transparent manner. Aim: This study aimed to establish the intra- and inter-rater reliability, and convergent validity of the RUN-PC Triage Tool and generate recommended response times. Design: An online survey of palliative care intake officers applying the RUN-PC Triage Tool to a series of 49 real clinical vignettes was assessed against a reference standard: a postal survey of expert palliative care clinicians ranking the same vignettes in order of urgency. Setting/Participants: Intake officers ( n = 28) with a minimum of 2 years palliative care experience and expert clinicians ( n = 32) with a minimum of 10 years palliative care experience were recruited from inpatient, hospital consultation and community palliative care services across metropolitan and regional Victoria, Australia. Results: The RUN-PC Triage Tool has good intra- and inter-rater reliability in inpatient, hospital consultation and community palliative care settings (Intraclass Correlation Coefficients ranged from 0.61 to 0.74), and moderate to good correlation to expert opinion used as a reference standard (Kendall’s Tau rank correlation coefficients ranged from 0.68 to 0.83). Conclusion: The RUN-PC Triage Tool appears to be a reliable and valid tool for the prioritisation of patients referred to specialist inpatient, hospital consultation and community palliative care services.

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Triaging the Terminally Ill—Development of the Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool

Cited by 5 publications

References 47 publications

Winners and Losers in Palliative Care Service Delivery: Time for a Public Health Approach to Palliative and End of Life Care

Winners and Losers in Palliative Care Service Delivery: Time for a Public Health Approach to Palliative and End of Life Care

Using a validated case mix tool for use in the telephone-assisted triage of patients in a specialist palliative care community setting: a consecutive case series

Validation of the responding to urgency of need in palliative care (RUN-PC) triage tool

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