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Data Element Detail

Episode of admitted patient care-palliative care phase
Identifying and Definitional Attributes
QH 040606 v3
Data Element
Data Element
Draft
30-Mar-2016		Current
15-Aug-2016		Superseded
29-Jan-2018
Standard
01-Jul-2016
30-Jun-2017
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.

There are only three phases in the paediatric palliative care branch in AN-SNAP version 4: stable, complex and terminal. As there are no paediatric versions of the palliative care phase tool, a paediatric patient is considered to be in the complex phase when the palliative care phase tool indicates an unstable or deteriorating phase. Therefore, the unstable or deteriorating phase codes should be reported as assessed for paediatric patients.

Code 01 Stable
The patient symptoms are adequately controlled by established 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
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 time and has a severely limited attention span.
- Increasingly 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 focussed on emotional and spiritual issues as a prelude to bereavement.
Queensland Hospital Admitted Patient Data Collection (QHAPDC):
Can be null for admitted patient records with Sub-acute and non-acute activity.
Must not be null if SNAP type = PAL.
Validated against a list of phase type codes.
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 reporting of the national data element, Episode of admitted patient care-palliative care phase (NHDD), 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 - 2
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementEpisode of admitted patient care-palliative care phaseQH 040606 Version 2Superseded
Has been superseded byData ElementData ElementEpisode of admitted patient care-palliative care phaseQH 040606 Version 4Current
Implementation in Metadata Sets

Implemented

  • 1 - 3
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 1ConditionalSuperseded01-Jul-201630-Jun-2017
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Private Facility Data Supply Requirement (DSR) 2016-2017QH 020315 Version 1ConditionalSuperseded01-Jul-201630-Jun-2017
Data Supply RequirementHHS Service AgreementQueensland Hospital Admitted Patient Data Collection (QHAPDC) Public Hospital Services Data Supply Requirement (DSR) 2016-2017QH 020314 Version 1ConditionalSuperseded01-Jul-201630-Jun-2017
Source and Reference Attributes
Australian Institute of Health and Welfare
METeOR data element: Episode of admitted patient care-palliative care phase, code N, identifier 611627, Health standard 19/11/2015 https://meteor.aihw.gov.au/content/index.phtml/itemId/611627/meteorItemView/long
Palliative care; SNAP;