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Implementing outcome measures in palliative care: what works and what doesn’t

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Outcome measures (tools that measure a change in a person’s health or wellbeing) have gained popularity in palliative care and are being increasingly used. These measures can be used to demonstrate the benefit of palliative care, and research has shown that they also improve symptom recognition and communication between patients and professionals. The Outcomes Assessment and Complexity Collaborative (OACC) has developed a core set of outcome measures for palliative care. OACC has also worked to implemented these measures,  which can be adapted for use across a variety of settings. The hospice sector – particularly Hospice UK – has also played an important role in supporting the use of these outcome measures in palliative care by working with the OACC team and organising training and seminars, and promoting their use. This growing use of outcome measures in palliative care practice led us to research how these measures were being routinely implemented. The key to the successful use of outcome measures lies in their implementation. We asked healthcare professionals (doctors, nurses and allied health professionals), as well as patients and families who had used these outcome measures, what they thought about how these measures were implemented and used in practice. We have presented the detailed findings in our paper, which shows what our study participants thought worked and didn’t work. We also present some guidance for the implementation of outcome measures in palliative care services. A key finding is that everyone in our study, from patients to clinicians, recognised the importance of how the information collected from these outcome measures was used. Ticking a box on a piece of paper or an electronic form is not useful. We need to communicate to patients how their data from these measures is being used. We also need to communicate and demonstrate to healthcare professionals how this data can improve clinical practice and services, and we need to communicate this data from outcome measures effectively to funders and commissioners. Some suggestions about how to use the information from outcome measures (made by participants in our study) have been reported in our paper. You may have already found effective ways of doing this in your own service and clinical practice. However, sometimes there may be a gap between collecting information from outcome measures and effectively using this information. If you don’t use the outcomes data, then you have only undertaken half the work! Our paper shows that this is an important component to successful implementation of outcome measures and needs to be given further consideration. We also need to share best practice with each other to make sure this isn’t just a tick box exercise, and use these measures effectively to improve outcomes for patients and families. Reference Pinto C, Bristowe K, Witt J, Davies JM, de Wolf-Linder S, Dawkins M, Guo P, Higginson IJ, Daveson B, Murtagh FE. Perspectives of patients, family caregivers and health professionals on the use of outcome measures in palliative care and lessons for implementation: a multi-method qualitative study. Annals of palliative medicine. 2018 Sep 20;7:S137-50.

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