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2014 Data Summary
PCQN Member Conference Call
February 17th, 2015
• 2014 Data Review
• New Database Features
• See you at AAHPM!
• PCQN Conference: May 12-13,
registration details coming soon!
Agenda
• Total Consults: 6402 from 16 sites
• Patients Seen: 5954, 93%
• Age: 72 years (mean)
• Sex: 52% female
• PPS Score: 34% (mean)
Demographics
Referral Location
42
27
23
5
1
1
1
0 10 20 30 40 50
Medical/Surgical
Telemetry/Step Down
Critical Care
Emergency Department
Skilled Nursing Facility
Other
Unknown
Frequency (%)
Referral Location – Med/Surg
18
28 32 33 35 38 41 44 46 46 46
50 58 58
73
98
41
0
10
20
30
40
50
60
70
80
90
100
Fre
qu
en
cy (
%)
Hospitals
Reason for Consult
74
17
17
10
8
6
3
0 20 40 60 80
Goals of care/ACP
Pain Management
Hospice Referral
Other Symptom Mgmt
Comfort Care
Other
Withdraw Intervent
Frequency (%)
Reason for Consult: Goals of Care/Advance Care Planning
27
60 63 65 57
71 74 76 81 82 84 84 84
94 99 100
74
0102030405060708090
100110
Fre
qu
en
cy (
%)
Hospitals
Primary Diagnosis
34
12
11
10
6
5
4
4
4
2
6
2
0 10 20 30 40
Cancer
Cardiovascular
Pulmonary
Neuro/Stroke
Complex/Failure to Thrive
Infectious/Immunological
Renal
Hepatic
Dementia
Trauma
Other
Unknown
Frequency (%)
Primary Diagnosis - Cancer
8 11 20 23
27 28 31 34 37 39 39 41 42
52 55
97
34
0
10
20
30
40
50
60
70
80
90
100
Fre
qu
en
cy (
%)
Hospitals
Code Status at Time of Consult
52
5
41
2 0
20
40
60
80
Full Partial DNR/DNI Pend/Unk
Fre
qu
en
cy (
%)
PC teams clarify code status in 44% of consults
Advance Directive
14
78
8 2
0
20
40
60
80
Yes No Pending Completed
Fre
qu
en
cy (
%) “Completed” is % of
cases w/o AD on chart at
time of consult
POLST – Of those discharged alive, not full code at consult
16
76
8
21
0
20
40
60
80
Yes No Pend/Unk Completed
Fre
qu
en
cy (
%)
“Completed” is % of cases w/o POLST on chart at time of consult
Disciplines Involved in Consult
53
49
48
31
16
9
3
2
0 20 40 60
Physician
Social Worker
Chaplain
Registered Nurse
Nurse Practitioner
Clinical Nurse Specialist
Other
Pharmacist
Frequency (%)
Family Meetings
34 38
15
6 4 3
0
20
40
0 1 2 3 4+ Pending
Fre
qu
en
cy (
%)
Number of family meetings
A family meeting can be scheduled or spontaneous and includes key member(s) of the PC team, key members of the patient’s family, and addresses a wide range of issues
Outcomes: Screened Pos/Intervened
62
81
57
85
56
89
52
86
71
94
0
20
40
60
80
100
Screened Pos Intervened
Fre
qu
en
cy (
%)
Pain Non-pain SX Psychosocial Spiritual ACP/GOC
Length of Stay
• LOS Prior to Consult
– 5.4 days (mean), 3 days (median)
• LOS During Consult
– 6 days (mean), 4 days (median)
• Number of contacts with pt
– 2 (mean/median)
• Pts w/ assessment w/in 1 day of admission: 31%
Length of Stay
2 3 3
2 2
4
2 3
4 4 3
5
2
4 3 3
5
5 4
3 4
5
4
4
4 5 7
4
3
4 7
4
0
1
2
3
4
5
6
7
8
9
10
Day
s
Prior to consult During Consult
First to Last Assessment Improvement
82 75
95
73
0
20
40
60
80
100
Pain Anxiety Nausea/Vomiting Dyspnea
Freq
ue
ncy
(%
)
Discharge Disposition
22
38
20
0
20
40
60
80
Died Home Home with Hospice
Fre
qu
en
cy (
%) Of the 78% of
patients
d/c’d alive
Disposition Location
22
38
17
11
6
2 4
0
10
20
30
40
Dead Home ECF Hosp Inpt ResCare/Ass
Live
Non-HospInpt
Other
Fre
qu
en
cy (
%)
• Monthly conference calls to promote
a coordinated, mentored QI project
– Choosing a topic and outcomes
– Teaching about QI
– Fishbone brainstorm
– Process mapping
– QI workshop
– Reports
QI Collaborative: Pain Management
76%
63%
83% 81% 81%
56%
65%
71% 74%
68%
61%
78%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Jan(N=25)
Feb(N=30)
Mar(N=24)
April(N=26)
May(N=31)
Jun(N=36)
Jul(N=23)
Aug(N=24)
Sep(N=23)
Oct(N=37)
Nov(N=41)
Dec(N=23)
Fre
qu
en
cy (
%)
QI Collab: Pts w/ moderate to severe pain at time of 1st assessment who improve by 2nd assessment (within 72 hours) - 2014
Average: 70%
Intervention Period Planning Period Baseline
Pain Management Referrals
2 8 8 9 11 13 14 15
19 21 22 24 27
31 33
58
17
0
10
20
30
40
50
60
70
Fre
qu
en
cy (
%)
Hospitals
Symptom Improvement - Pain
50 52
62 63 65 67 69 69 70 78 80 83
69 70
0
10
20
30
40
50
60
70
80
90
Fre
qu
en
cy (
%)
Hospitals
New Database Features
New Features - Personalization
New Features - Dashboard
New Features – Disposition Services
New Features – User Notes
New Features – User Notes
New Features – Data Summary
New Features – Data Summary
New Features – Database Report
New Features – Database Report
New Features – EDS Upload Option
• Contact PCQN
• Use demo site to test upload process
• Begin submitting data
New Features – EDS Upload Option
New Features – Comparison Reports
New Features – Comparison Reports
New Features – Comparison Reports
• CaseMaker PCS is ready!
• Outpatient & community-based PC data collection
• Targeted comparisons and benchmarking with like hospitals
• 2x2 analysis
• Electronic data capture and download from EHR
• New QI Collaborative
• Revamped website
On the Horizon
Thank you!
