Authors: Annette Heffernan (SouthDoc), Dr Terence Adendorff (SouthDoc), Dr Eamonn Shanahan (GP, SouthDoc region), Dr Paul Gregan (Chair – Primary Palliative Care Steering Committee), Marie Lynch (IHF), Tony Duffy (IHF)

• The need to develop a standardised information transfer process from GPs to the Out-of-hours (OOH)

service for patients with palliative care needs was highlighted as a key priority in the recommendations

of the IHF/ICGP/HSE report, Primary Palliative Care in Ireland 1 published in 2011

• A study by Kiely (2013)2 highlighted that whilst 82% of Irish GPs do not routinely hand over information to the OOH

team for patients with palliative care needs, 96% would value a standardised way of transferring information

• In 2012 the IHF/ICGP/HSE Primary Palliative Care Steering committee commenced a project to develop

such an information transfer process

• A GP OOH Palliative Care handover form was developed and pre-piloted in the SouthDoc region in 2013

• A full evaluation was undertaken to review the form and the overall process to support a full pilot

Refining a GPOut-of-hours Palliative

Care Handover Form

Introduction

Next Steps

1. A pilot of Version 2 and the updated process will be undertaken in SouthDoc in 2014

2. The pilot project will be fully evaluated

3. The findings of the evaluation will inform national application of the process

This project is an initiative of the IHF/ICGP/HSE Primary Palliative Care programme

• The handover form has been redesigned. Version 2 has been condensed from three pages to one.

• The number of data fields to complete has been reduced from 59 to 34 (Data may still be completed on the form in the ‘additional information’ section)

Fields comply with HIQA National Standard Demographic Dataset and Guidance for use in health and social care settings in Ireland 3

• The overall operating process has been streamlined with the removal of the need for

transcribing data

• A comprehensive education and monitoring/evaluation plan has been developed to

support the pilot

Outcomes

Results Methods

• A process mapping exercise to review the

overall process

• Analysis of data field completion

• Qualitative feedback on the use of the form

and the overall process was obtained from

following stakeholders:

a) GPs who competed the handover form

b)Triage Nurses who inputted the data

c) OOH GPs who saw patients who had

been flagged

• A total of 17 forms were received during the study

period. 53% related to non-cancer patients

• Completion rates for data fields varied e.g. Diagnosis

88%, CPR status 88% , Allergies 29%, Community

supports 69%

• GPs highlighted that the form was time-consuming to

complete and fax

• SouthDoc triage staff highlighted that data from the

form was time-consuming to input onto the Adastra

system

• SouthDoc staff raised concerns about the potential for

transcription errors occurring during data input

1. Irish Hospice Foundation /ICGP/HSE Primary Palliative Care in Ireland : Identifying improvements in primary care to support the care of those in

their last year of life 2011: Dublin 2. Kiely F, Murphy , O’Brien T. BMJ Supportive & Palliative Care 2013;3: 405-411

3. HIQA National Standard Demographic Dataset and Guidance for use in health and social care settings in Ireland 2013:Dublin February 2014

The Irish Hospice Foundation, Morrison Chambers, 32 Nassau Street, Dublin 2 01 6793188

marie.lynch@hospicefoundation.ie tony.duffy@hospicefoundation.ie www.hospicefoundation.ie