Before taking steps to establish a program, the planning team should work with key stakeholders to develop a plan for measuring and monitoring program impact.

This section contains:

• Categories of Measurement
• What Data to Track
• Data Sources and Management
• Selecting Clinical Assessment and Evaluation Tools

Categories of Measurement

Four categories of measurement are recommended by CAPC:

1. Operational data (e.g. volume and type of referrals, date of admission/consultation)
2. Clinical data (e.g. pain and symptom control)
3. Customer data (e.g. patient, family, and health care provider satisfaction surveys)
4. Financial data (e.g. billing revenues, cost per day, length of stay)

What Data to Track

Operational Data: A CAPC consensus panel has published a detailed list of data points to measure for palliative care consultation programs and inpatient units.

• Operational Features for Hospital Palliative Care Programs: Consensus Recommendations
• Center to Advance Palliative Care Palliative Care Consultation Service Metrics: Consensus Recommendations

Clinical Data: Clinical data reflects the work of the palliative care team in caring for patients and families. This data should be documented in the medical record as appropriate to the consultation question. Periodic chart reviews to assess compliance with documentation of key clinical data is recommended.

• Assessment and management of physical/psychological/spiritual symptoms
• Establishment of patient-centered goals of care
• Support to patient and family caregivers
• Management of transitions across care sites

Customer Data: CAPC suggests the following data be collected periodically to assess customer satisfaction:

• Patient and family satisfaction
• Referring clinician satisfaction

Financial Data: CAPC suggests the following data be tracked and reported at least annually:

• Billing revenue
• Philanthropic revenue
• Mean direct (variable) cost per day, before and after consultation

Other Data: These data elements may be helpful in documenting the breadth of palliative care program activities:

• Educational contact hours to staff and community groups
• Publications
• Grants
• Research projects

Data Sources and Management

In creating a measurement and monitoring system programs are encouraged to:

• Identify the data elements that are needed/requested by key stakeholders
• Identify the variables currently collected or stored in existing hospital databases
• Choose or develop standardized tools to gather information that cannot be obtained from hospital databases
• Work with an appropriate professional (many programs employ a graduate student or intern for this purpose) to build a database or spreadsheet to store this information

Data should be kept in a secure computerized database that permits easy analysis and standardized reporting; options include a simple Access database or Excel tracking sheet.

Selecting Clinical Assessment and Evaluation Tools

Examples of tools used by existing palliative care programs can be found in Tools for Palliative Care Programs.

CAPC's Guide to Building a Hospital-Based Palliative Care Program expands the information on this website and provides detailed information and sample tools for measuring the quality and impact of programs.