Clinical audit by a palliative care team

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Abstract
Objective: To develop a method of audit for, and evaluate the work of, a palliative care support team. Methods: Through observation and discussion with the team, 14 items, forming the Support Team Assessment Schedule (STAS), were identified which were considered to represent independent care objectives. Definitions of scale points (0-6) were agreed for each item. The team made ratings at their weekly meeting for each patient during a 12-month period. Results: Of 124 patients seen by the team there were a minimum of two recordings for 82 patients which provided a measure of the outcome of care. The group mean scores showed statistically significant improvements on all items, but there were differences between items in the extent of improvement. The STAS helped to make the team's assessments more systematic, and feedback of the information focused attention on the team's treatment of terminal dyspnoea. Conclusion: Audit of palliative care is practicable by this method. The approach could also be developed for use in inpatient hospital and hospice settings.