Early identification of patients with palliative care needs in the acute hospital setting - Evaluation of a digital mortality prediction tool and clinician training needs
Identification of patients who may need palliative care assessment or intervention following admission to an acute hospital.
This is a retrospective cohort study with qualitative elements (focus groups and training needs analysis questionnaire). The quantitative element of this project will calculate the HOMR Now! score for a cohort of patients previously admitted to hospital at 3 UK NHS acute hospital sites. There will be follow-up at one year to evaluate the predictive accuracy of the score. Baseline data will be collected on whether these patients were referred to palliative care services or had advance care planning. The software developed to apply the HOMR Now! algorithm will not be used for any medical or interventional purpose in this study but solely to address the principal research question. There will be no change to clinical management for these patients, however the study may lead on to a future separate research proposal examining prospective use of the HOMR Now! tool. Qualitative evaluation will comprise focus groups with clinicians, patients and carers/family. These will gather in-depth, rich data to help evaluate the acceptability of using such a clinical tool. A training needs analysis will also examine staff learning needs required to support any potential future implementation study.
For focus groups: 1. Patients who have been admitted to hospital in the last 10 years 2. Carers/relatives of patients who have had a hospital admission in the last 10 years 3. Age over 18 4. Health professionals working in the acute hospital setting at any of the registered study sites
1. Patients lacking mental capacity to consent to involvement 2. Patients under 18 years of age