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

Data Element Attributes

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termPalliative care phase
METEOR identifier:Help on this term611627
Registration status:Help on this term

Health, Superseded 25/01/2018

Tasmanian Health, Superseded 19/05/2020

Definition:Help on this term

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:Help on this termEpisode of admitted patient care—palliative care phase
Value Domain:Help on this termPalliative care phase code N

Value domain attributes

Representational attributes

Representation class:Help on this termCode
Data type:Help on this termNumber
Format:Help on this termN
Maximum character length:Help on this term1
  ValueMeaning
Permissible values:Help on this term1Stable
  2Unstable
  3Deteriorating
  4Terminal
Supplementary values:Help on this term9
 
Not reported
 

Collection and usage attributes

Guide for use:Help on this term

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:Help on this term

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 Help on this term

Collection and usage attributes

Guide for use:Help on this term

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 the Australian National Subacute and Non‐Acute Patient (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.

Collection methods:Help on this term

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:Help on this term

Independent Hospital Pricing Authority

Reference documents:Help on this term

Green J, Gordon R, Kobel C, Blanchard M and Eagar K. 2015. AN-SNAP V4 User Manual. Independent Hospital Pricing Authority, Sydney. Viewed 15 June 2015, http://ihpa.gov.au/internet/ihpa/publishing.nsf/
Content/C48C490F92D74111CA257AD900132744/$File/
AN-SNAP%20classification%20version%204%20User%20Manual.pdf

Relational attributes

Related metadata references:Help on this term
Supersedes Episode of admitted patient care—palliative care phase, code N

        Health, Superseded 19/11/2015

        Independent Hospital Pricing Authority, Standard 31/10/2012

Has been superseded by Episode of admitted patient care—palliative care phase, code N

        Independent Hospital Pricing Authority, Standard 03/11/2016

Implementation in Data Set Specifications:Help on this term
All attributes +
Admitted subacute and non-acute hospital care NBEDS 2016-17

        Health, Superseded 03/11/2016

DSS specific attributes +
Implementation start date: 01/07/2016
Implementation end date: 30/06/2017
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:

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.


Tasmanian Subacute/Non-acute Data Set - 2016

        Tasmanian Health, Superseded 18/01/2018

DSS specific attributes +
Implementation start date: 01/07/2016
Implementation end date: 30/06/2017

Tasmanian Subacute/Non-acute Data Set - 2017

        Tasmanian Health, Superseded 18/01/2018

DSS specific attributes +
Implementation start date: 01/07/2017
Implementation end date: 30/06/2018

Tasmanian Subacute/Non-acute Data Set - 2018

        Tasmanian Health, Superseded 06/05/2020

DSS specific attributes +
Implementation start date: 01/07/2018
Implementation end date: 30/06/2019

Tasmanian Subacute/Non-acute Data Set - 2019

        Tasmanian Health, Superseded 06/05/2020

DSS specific attributes +
Implementation start date: 01/07/2019
Implementation end date: 30/06/2020

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