Allsop, MJ orcid.org/0000-0002-7399-0194, Kite, S, McDermott, S et al. (3 more authors) (2017) Electronic palliative care coordination systems: Devising and testing a methodology for evaluating documentation. Palliative Medicine, 31 (5). pp. 475-482. ISSN 0269-2163
Abstract
Background: The need to improve coordination of care at end of life has driven electronic palliative care coordination systems implementation across the United Kingdom and internationally. No approaches for evaluating electronic palliative care coordination systems use in practice have been developed. Aim: This study outlines and applies an evaluation framework for examining how and when electronic documentation of advance care planning is occurring in end of life care services. Design: A pragmatic, formative process evaluation approach was adopted. The evaluation drew on the Project Review and Objective Evaluation methodology to guide the evaluation framework design, focusing on clinical processes. Setting/participants: Data were extracted from electronic palliative care coordination systems for 82 of 108 general practices across a large UK city. All deaths (n = 1229) recorded on electronic palliative care coordination systems between April 2014 and March 2015 were included to determine the proportion of all deaths recorded, median number of days prior to death that key information was recorded and observations about routine data use. Results: The evaluation identified 26.8% of all deaths recorded on electronic palliative care coordination systems. The median number of days to death was calculated for initiation of an electronic palliative care coordination systems record (31 days), recording a patient’s preferred place of death (8 days) and entry of Do Not Attempt Cardiopulmonary Resuscitation decisions (34 days). Where preferred and actual place of death was documented, these were matching for 75% of patients. Anomalies were identified in coding used during data entry on electronic palliative care coordination systems. Conclusion: This study reports the first methodology for evaluating how and when electronic palliative care coordination systems documentation is occurring. It raises questions about what can be drawn from routine data collected through electronic palliative care coordination systems and outlines considerations for future evaluation. Future evaluations should consider work processes of health professionals using electronic palliative care coordination systems.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016, the Author(s). This is an author produced version of a paper accepted for publication in Palliative Medicine. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Palliative care; electronic palliative care coordination systems; advance care planning; end of life care; technology |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Primary Care (Leeds) |
Funding Information: | Funder Grant number NHS Leeds South and East CCG No Ext Ref Given |
Depositing User: | Symplectic Publications |
Date Deposited: | 11 Aug 2016 11:44 |
Last Modified: | 30 Jun 2017 20:42 |
Published Version: | https://dx.doi.org/10.1177/0269216316663881 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/0269216316663881 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:103380 |