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

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 term445942
Registration status:Help on this termHealth, Superseded 19/11/2015
Independent Hospital Pricing Authority, Standard 31/10/2012
Definition:Help on this termThe 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:Episode of admitted patient care—palliative care phase

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
Permissible values:Help on this term
ValueMeaning
1Stable
2Unstable
3Deteriorating
4Terminal
Supplementary values:Help on this term
9Not 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

Collection and usage attributes

Guide for use:Help on this termThe bereavement phase of palliative care must not be recorded when reporting this data element.
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 termIndependent Hospital Pricing Authority

Relational attributes

Related metadata references:Help on this term

Has been superseded by Episode of admitted patient care—palliative care phase, code N Health, Superseded 25/01/2018, Tasmanian Health, Endorsed 22/12/2016

Implementation in Data Set Specifications:Help on this term
All attributes +

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

DSS specific attributes +

Admitted sub-acute and non-acute care activity based funding DSS 2012-2013 Independent Hospital Pricing Authority, Superseded 11/10/2012

DSS specific attributes +

Admitted subacute and non-acute hospital care DSS 2014-15 Health, Superseded 13/11/2014

DSS specific attributes +

Admitted subacute and non-acute hospital care DSS 2015-16 Health, Superseded 19/11/2015

DSS specific attributes +
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