Episode of admitted patient care—palliative care phase, code N

Identifying and definitional attributes
Metadata item type:	Data Element
Short name:	Palliative care phase
METEOR identifier:	445942
Registration status:	Health, Superseded 19/11/2015 Independent Hospital Pricing Authority, Standard 31/10/2012
Definition:	The patient's stage of illness or situation within the episode of care in terms of the recognised phases of palliative care, as represented by a code.

Data element concept attributes

Identifying and definitional attributes

Data element concept:

Episode of admitted patient care—palliative care phase

METEOR identifier:

445933

Registration status:

Health, Standard 11/04/2014
Independent Hospital Pricing Authority, Superseded 03/11/2016
Tasmanian Health, Superseded 19/05/2020

Definition:

The patient's stage of illness or situation within the episode of care in terms of the recognised phases of palliative care.

Object class:

Episode of admitted patient care

Property:

Palliative care phase

Value domain attributes

Identifying and definitional attributes

Value domain:

Palliative care phase code N

METEOR identifier:

445936

Registration status:

Health, Standard 11/04/2014
Independent Hospital Pricing Authority, Superseded 03/11/2016
Tasmanian Health, Superseded 19/05/2020

Definition:

A code set describing the phases of palliative care.

Representational attributes

Representation class:

Code

Data type:

Number

Format:

Maximum character length:

Permissible values:

Value	Meaning
1	Stable
2	Unstable
3	Deteriorating
4	Terminal

Supplementary values:

Value	Meaning
9	Not reported

Collection and usage attributes

Guide for use:

The palliative care phase is the stage of the palliative care patient’s illness.

CODE 1 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 2 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 3 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 4 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.

CODE 9 Not reported

The phase of the illness has not been reported.

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.

Source and reference attributes

Origin:

Palliative Care Outcomes Collaboration (PCOC) 2009. PCOC V2 Data Definitions and Guidelines. Australian Health Services Research Institute, University of Wollongong, Wollongong. Viewed 24 August 2012,
http://ahsri.uow.edu.au/content/groups/public/@web/@chsd/@pcoc/
documents/doc/uow090306.pdf

Data element attributes

Collection and usage attributes

Guide for use:

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

Collection methods:

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.

Source and reference attributes

Submitting organisation:

Independent Hospital Pricing Authority

Relational attributes

Related metadata references:

Implementation in Data Set Specifications:

Activity based funding: Admitted sub-acute and non-acute hospital care DSS 2013-2014
Independent Hospital Pricing Authority, Standard 11/10/2012

Implementation start date: 01/07/2013

Implementation end date: 30/06/2014

Conditional obligation:

Only required to be reported for episodes of admitted patient care with hospital service-care type, code N[N].N recorded as 3.0 palliative care.

Only required to be reported when Episode of admitted patient care-assessment only indicator, yes/no, code N value recorded as 2 no.

DSS specific information:

For episodes of admitted patient care with hospital service-care type, code N[N].N recorded as 3.0 palliative care, the palliative care phase must be reported for each palliative care phase if the episode of admitted patient care had more than one phase.

Admitted sub-acute and non-acute care activity based funding DSS 2012-2013
Independent Hospital Pricing Authority, Superseded 11/10/2012

Implementation start date: 01/07/2012

Implementation end date: 30/06/2013

Conditional obligation:

Only required to be reported for episodes of care for patients with a care type of palliative care.

Admitted subacute and non-acute hospital care DSS 2014-15
Health, Superseded 13/11/2014

Implementation start date: 01/07/2014

Implementation end date: 30/06/2015

Conditional obligation:

Only required to be reported for episodes of admitted patient care with Hospital service—care type, code N[N] recorded as Code 3, Palliative care.

Only required to be reported when the Episode of admitted patient care—clinical assessment only indicator, yes/no code N value is recorded as Code 2, No.

Not required to be reported for patients aged 16 years and under at admission.

DSS specific information:

For episodes of admitted patient care with Hospital service—care type, code N[N] recorded as Code 3, Palliative care, the palliative care phase must be reported for each palliative care phase if the episode of admitted patient care had more than one phase.

Admitted subacute and non-acute hospital care DSS 2015-16
Health, Superseded 19/11/2015

Implementation start date: 01/07/2015

Implementation end date: 30/06/2016

Conditional obligation:

Only required to be reported for episodes of admitted patient care with Hospital service—care type, code N[N] recorded as Code 3, Palliative care.

DSS specific information: