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Lack of Documentation of Evidence-Based Prognostication in Cancer Patients by Inpatient Palliative Care Consultants

2015; Mary Ann Liebert, Inc.; Volume: 18; Issue: 4 Linguagem: Inglês

10.1089/jpm.2014.0331

1096-6218

Andrew Bruggeman, Susan Heavey, D. Joseph, Carolyn Revta, Eric Roeland,

Childhood Cancer Survivors' Quality of Life

Prognostication plays a key role in palliative care (PC). It is critical for advance care planning, determining hospice eligibility, and communication. In contrast to subjective clinical prognostication, evidence-based prognostication (EBP) uses existing validated data to quantify prognosis; however, the extent to which PC providers use EBP is limited.The objective was to analyze documentation of EBP by PC providers in the absence of an inpatient consultation note template at a single academic medical center.We retrospectively evaluated prognostic documentation of inpatient PC consultations on oncology patients at a single academic hospital. Ratings of Eastern Cooperative Oncology Group (ECOG) Scale, Karnofsky Performance Scale (KPS), Palliative Performance Scale, and/or activities of daily living (ADLs) were considered documentation of functional status. PC-specific documentation of EBP included the Palliative Prognostic Index and/or Palliative Prognostic Score.There were 412 inpatient PC consultations for oncology patients (2012-2013). Reasons for consultation included goals of care (n=108), symptom management (n=181), or both (n=123). In the absence of a note template, functional status was documented in 6% (n=24) of consultation notes, while no consultation notes contained EBP documentation of the Palliative Prognostic Index and Palliative Prognostic Score.This retrospective analysis conducted at a single academic medical center suggests poor documentation by PC providers of EBP in the absence of a consultation note template. Research and educational opportunities exist to evaluate barriers to EBP utilization and documentation by PC providers.