{
  "abstract": "Background Palliative care is becoming increasingly complex; people are living longer with multiple chronic conditions, frailty and cognitive decline, with family and caregiver need adding to this increase (Hodiamont, Jünger, Leidl, et al. BMC Health Serv Res 2019:19:157). Therefore, robust tools are required for assessing patient acuity and dependency.Aim To develop and implement an acuity and dependency tool for use in palliative care that captures the complexity of needs in order to guide workforce planning, service delivery and improve the quality of care.Method A review of existing acuity and dependency and palliative care assessment tools was undertaken. The Resource Utilisation Group Activities of Daily Living (RUG-ADL) (Poss, Hirdes, Fries, et al. Med Care. 2008;46(4):380-7) was selected to evaluate functional status using four key domains: bed mobility, transfers, toileting and eating (score range 4-18) and the Palliative Care Problem Severity Score (PCPSS) (Masso, Allingham, Johnson, et al. Palliat Med. 2015;30(5):479-85) used to score the severity of four key problems – pain, other physical symptoms, psychological/spiritual distress, and family issues (score range 0-12). Additionally, staffing numbers and skill mix were incorporated to align care needs with available resources, along with the National Patient Safety Agency’s risk definitions providing a standardised approach to identify safety risks (National Patient Safety Agency. Risk matrix for risk managers [internet]. NPSA; 2008). Workload data was also collected to support the analysis, by identifying patterns and correlations. Following staff training, data was collected daily and analysed at six months and one year.Results Analysis of the data identified gaps in staffing and skill mix, highlighting areas where resources were insufficient to meet patient needs, however, in order to achieve a comprehensive understanding of staffing need and patient care requirements it was necessary to triangulate alongside care hours per patient day and bed occupancy data.Conclusion By combining physical dependency and symptom complexity scores with staffing, safety and workload considerations, a more holistic view of patient need was achieved. Further study is required to validate effectiveness across hospice inpatient settings.The authors gratefully acknowledge the Palliative Care Outcomes Collaboration (PCOC) for supporting the use of their assessment tools.",
  "authors": [
    {
      "affiliations": [
        "Les Bourgs Hospice, St Andrews, Guernsey"
      ],
      "name": "Sharon Le Prevost"
    }
  ],
  "title": "P-77 Developing an acuity and dependency tool for hospice inpatient palliative care",
  "uid": "50c5db55-deff-51fa-a054-f699a548545c"
}