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PCQN Database
- Operational since June 2013
- 4 sites currently submitting data
- Over 1400 consults
- Standardized reports by site and for
PCQN Data Steven Pantilat, MD David ORiordan , PhD Ashley Bragg - - PowerPoint PPT Presentation
PCQN Data Steven Pantilat, MD David ORiordan , PhD Ashley Bragg - - PowerPoint PPT Presentation
PCQN Data Steven Pantilat, MD David ORiordan , PhD Ashley Bragg November 21, 2013 PCQN Database Operational since June 2013 4 sites currently submitting data Over 1400 consults Standardized reports by site and for entire PCQN
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PCQN Patient Characteristics
Characteristics Number of patients analyzed 1386 (4 hospitals) Age (Years) Mean= 69, Range: 20 - 104 Gender (Female) 50% LOS Pre referral (Days) Mean= 7, Range: 1 - 129 LOS during consult (Days) Mean= 6, Range: 1 - 162 Days Symptoms assessed Mean= 2.6
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Length of Stay
8 11 6 3 6 10 4 5 5 10 15 20 25 Hospital 1 Hospital 2 Hospital 3 Hospital 4 Days Prior to consult During Consult 3 Days* 4 Days* 2 Days* 2 Days*
*: Days symptoms were assessed during consultation
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Location at Time of Referral
40 26 27 5 0.1 0.2 2 10 20 30 40 50 Medical/Surgical Critical Care Telemetry/Stepdown Emergency Dept. Ambulatory/Outpt. Other Unknown Frequency (%)
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Referral From Med/Surg and Critical Care
48 40 37 25 30 22 25 23 10 20 30 40 50 60 Hospital 1 Hospital 2 Hospital 3 Hospital 4 Frequency (%) Medical/Surgical Critical Care
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Reason for Consultation
69 21 17 14 12 5 3 8 1 10 20 30 40 50 60 70 80 Goals of care Pain management Symnptom management Hospice referral Transfer to comfort care bed Comfort care Withdraw interventions Other No reason given Frequency (%)
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Consultation for Pain Management
29 23 7 22 5 10 15 20 25 30 35 Hospital 1 Hospital 2 Hospital 3 Hospital 4 Frequency (%)
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Primary Diagnosis
43 12 11 10 4 4 4 3 2 2 2 1 1 1 10 20 30 40 50
Cancer Cardiac Neuro/stroke Pulmonary Failure to thrive Renal Hepatic Dementia Gastro. Immune Defficiencies Trauma Other Unknown Vascular
Frequency (%)
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Primary Diagnosis: Cancer
59 43 35 19 10 20 30 40 50 60 70 Hospital 1 Hospital 2 Hospital 3 Hospital 4 Frequency (%)
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Improved Symptom Scores
53 47 47 42 20 40 60 80 100 Nausea Pain Dyspnea Anxiety Frequency (%) 1st –> Last day Day 1 > 0
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Improved Pain Score by Hospital
48 40 42 71 20 40 60 80 100 Hospital 1 (n=84) Hospital 2 (n=14) Hospital 3 (n=19) Hospital 4 (n=5) Frequency (%) 1st –> Last day Day 1 > 0
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Disciplines in Consultation
65 43 39 19 12 20 40 60 80 100 Physician Social Worker Chaplain Registered Nurse
- Clin. Nurse Specialist
Frequency (%)
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Number of Family Meetings
20 48 18 7 4 1 1 20 40 60 1 2 3 4 5 >5 Frequency (%) Number of family meetings
A family meeting can be scheduled or spontaneous and includes key member(s)
- f the PC team, key member(s) of the
patient’s family, and addresses a wide range of issues (e.g. more than just symptoms or just disposition)
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Family Meetings by Hospital
22 41 21 8 9 41 35 12 8 4 19 55 16 7 5 4 66 21 7 2
20 40 60 80 1 2 3 4+ Frequency (%) Number of family meetings Hospital 1 Hospital 2 Hospital 3 Hospital 4
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Palliative Performance Scale
0.3 21 10 14 16 13 6 2 1 1 0.4 10 20 30 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Frequency (%)
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Code Status
46 8 44 2 20 40 60 80 100 Full Partial DNR/DNI Unknown Frequency (%)
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Code Status by Hospital
48 6 44 3 48 9 40 3 38 15 47 57 1 42
20 40 60 80 100 Full Partial DNR/DNI Unknown Frequency (%) Code Status Hospital 1 Hospital 2 Hospital 3 Hospital 4
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Discharge Disposition
37 28 43 29 36 17 13 28 7 18 34 34 31 18 30
10 20 30 40 50 Hospital 1 Hospital 2 Hospital 3 Hospital 4 Mean Frequency (%) Home Home with Hospice Died
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PCQN Data
- Variation across sites
- Process and outcome measures
- Data provides ranges and targets
– Deeper dive to understand variation
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PCQN Data
- What stands out?
- What strikes you about the data?
- How would you use the data?
- Who would you want to share it with?
- What questions do the data raise?