A pilot implementation of palliative care screening in the primary care setting

Abstract

Palliative care is described by the World Health Organization (2020) as an approach that improves the quality of life of patients and their families who are facing problems associated with life-threatening illness. With palliative care, patients experience improved quality of life, decreased health care costs, and caregivers experience a greater support system. Despite these benefits, patients in the primary care setting are not being screened for palliative care needs, and therefore the aim of this doctor of nursing practice quality improvement project was formal palliative care screening in the primary care setting. This project was implemented at a primary care clinic with an aging population where before implementation there was no palliative care screening occurring, which made it an optimal clinic to implement screening. A six week implementation period took place between January 6, 2022, and February 24, 2022. Patients aged 70 and older who presented to the clinic for an appointment were screened for palliative care needs using the SPICT screening tool. Findings included: 68% of the patients that fit screening criteria were screened for palliative care needs; of those that were screened, 12% screened positive for palliative care needs; and healthcare staff reported a more than ideal satisfaction with the screening process and screening tool. Project results met two out of three SMART goals, as the goal that 100% of patients who fit screening criteria would be screened was not met, while the goal that the percent of positive would be reported and the goal that staff would have a more than ideal satisfaction with the screening process and tool were met. Though findings paralleled the literature that described the SPICT screening tool as an effective screening tool for palliative care needs and staff reported increased awareness and knowledge on palliative care needs for those patients who would benefit from it. Additionally, there is not enough data to decide implications for the community as a whole related to palliative care needs.