Developing an electronic SPICT TM alert
Aim:
To establish an electronic alert to flag patients who are being managed with a supportive and palliative approach, utilising SPICTTM as objective criteria for identification.
Encouraging clinical staff who view the clinical record to focus on comfort and quality of life while still considering acute interventions as appropriate to the patient’s personal and clinical needs and preferences.
Methods:
The lead author engaged with consultant colleagues and collaborated with the University of Edinburgh to develop the Coventry and Warwickshire SPICT. UHCW NHS Trust developed a Palliative Care e-Form in the Clinical Results Reporting System (CRRS) using this tool. The system is utilised in hospital and is visible to community and hospice staff. The electronic alert is for patients who:-
• fulfil defined objective prognostic criteria
• are likely to be within the last year of life
• are being managed with a supportive and palliative approach to care
• may be carrying an advance care plan
An online learning module was developed and further revised with development of a local EPaCCS.
Results:
Total of 1917 palliative care alerts were uploaded from 3 Nov 2011 to 31 Dec 2017 by consultants or senior nursing/medical staff from 12 hospital specialties.1544 have now died: 81%
Mean time from date of upload of alert for all specialties to patient deathfor the last 5 years has been 150, 104, 88, 56 and 35 days.
Conclusion:
The alert helps facilitate appropriate care and prompts professionals uploading the alert to offer advance care planning and liaise with the GP to identify a key worker. Further research is needed to answer the questions: did the alert change patientmanagement?; did the alert impact on preferred place of care and death?; did the alert impact on referrals to specialist palliative care?
Authors:
Dr Sarah MacLaran, Consultant in Palliative Medicine, UHCW NHS Trust and The Myton Hospices
Wasim Hussain, Analyst Programmer, ICT Services, UHCW NHS Trust
Anwar Shaikh, Programme Analytics Specialist, Performance and Programme Management Office, UHCW NHS Trust
AumarTarzi, IT Systems Trainer, UHCW NHS Trust
Paula Yates, IT Training Manager, UHCW NHS Trust
Karl O’Sullivan-Smith, Head of Development, ICT Services, UHCW NHS Trust
Dr Claire Magee, Consultant in Palliative Medicine, Coventry and Warwickshire Partnership NHS Trust
29.01.18 final S.MacLaran