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Data Element Detail

Episode of admitted patient care-palliative care phase
Identifying and Definitional Attributes
QH 040606 v2
Data Element
Data Element
Draft
23-Apr-2013		Current
09-Jul-2013		Superseded
14-Aug-2016
Standard
01-Jul-2013
30-Jun-2016
The patient's stage of illness or situation within the episode of care in terms of the recognised phases of palliative care
Sub-acute admitted patient care.
Palliative care phase
Representational Attributes
Numeric Character
Code
N(2)
2
2
Permissible Values

Permissible_values

CodeDescription
01Stable
02Unstable
03Deteriorating
04Terminal care
Supplementary Values

Supplemenary_values

-
Collection and Usage Attributes
The palliative care phase is the stage of the palliative care patient's illness.

Palliative care phases are not sequential and a patient may move back and forth between phases. Palliative care phases provide a clinical indication of the type of care required and have been shown to correlate strongly with survival within longitudinal prospective studies.

The bereavement phase of palliative care must not be recorded when reporting this data element.

Code 01 Stable
The patient symptoms are adequately controlled by establishing management. Further interventions to maintain symptom control and quality of life have been planned. The situation of the family/carers is relatively stable and no new issues are apparent. Any needs are met by the established plan of care.

Code 02 Unstable
The patient experiences the development of a new unexpected problem or a rapid increase in the severity of existing problems, either of which require an urgent change in management or emergency treatment. The family/carers experience a sudden change in their situation requiring urgent intervention by members of the multidisciplinary team.

Code 03 Deteriorating
The patient experiences a gradual worsening of existing symptoms or the development of new but expected problems. These require the application of specific plans of care and regular review but not urgent or emergency treatment. The family/carers experience gradually worsening distress and other difficulties, including social and practical difficulties, as a result of the illness of the person. This requires a planned support program and counselling as necessary.

Code 04 Terminal care
Death is likely in a matter of days and no acute intervention is planned or required. The typical features of a person in this phase may include the following:
- Profoundly weak.
- Essentially bed bound.
- Drowsy for extended periods.
- Disoriented for a time and has a severely limited attention span.
- Increasing disinterested in food and drink.
- Finding it difficult to swallow medication.

This requires the use of frequent, usually daily, interventions aimed at physical, emotional and spiritual issues. The family/carers recognise that death is imminent and care is focused on emotional and spiritual issues as a prelude to bereavement.
Hospital service-care type (QHAPDC) must be code 30 Palliative care.
The type of phase is to be recorded at the start of the episode of admitted patient palliative care and for every subsequent change in phase thereafter during the same admitted patient episode.

The palliative care provider reviews the patient daily (or at each visit) and records phase changes if and when they occur during the episode.

For national reporting of the Episode of admitted patient care-palliative care phase data element the following mapping occurs:
Code 01 Stable is mapped to code 1 Stable.
Code 02 Unstable is mapped to code 2 Unstable.
Code 03 Deteriorating is mapped to code 3 Deteriorating.
Code 04 Terminal care is mapped to code 4 Terminal.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 3
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementPalliative care phase typeQH 040606 Version 1Superseded
Has been superseded byData ElementData ElementEpisode of admitted patient care-palliative care phaseQH 040606 Version 3Superseded
Relates toData ElementData Element ConceptEpisode of admitted patient careQH 041604 Version 1Current
Implementation in Metadata Sets

Implemented

  • 1 - 1
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 1ConditionalSuperseded01-Jul-201330-Jun-2016
Source and Reference Attributes
Australian Institute of Health and Welfare
METeOR data element: Episode of admitted patient care-palliative care phase, code N, identifier 445942, Independent Hospital Pricing Authority (IHPA) standard 31/10/2012 & Health standard 11/04/2014 https://meteor.aihw.gov.au/content/index.phtml/itemId/445942/meteorItemView/long
Palliative care; SNAP;