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CAPC Palliative Care Discussion Forum
Data Collection and Measurement
palliative Care Stats- benchmarkAuthor: mherman
Date: Apr 14, 2009 5:35 pm
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There are no benchmarks per se yet; the CAPC Registry project is designed to remedy that problem by gathering data nationwide on these kinds of metrics.
That being said, Lynn Spragens has used the following rule-of-thumb in her CAPC presentations: new programs typically see 0.5 to 1.0 new consults per staffed bed in the hospital; after three years, established programs typically see 1.0 to 1.5 new consults per staffed bed; by the 5th year a mature program may see 1.5 - 2.0 consults per staffed bed. For a 300-bed hospital this translates into 150-300 consults in year 1; 300-450 by year 3; 450-600 by year 5. This is based on Lynn's worth with scores of PC programs nationwide over the past 10 years.
I don't know of any stats regarding your second metric.
Regarding the third metric, the "delay" to PC referral from time of admission varies incredibly widely. Here is what I've dug out of the literature regarding the time that typically passes from admission to consult: In the first UHC benchmarking study (Twaddle 2007 JPM 10 (1) 86-98) the average was 9 days. Fromme 2006 JPM 9 (4) 903-911 reported 13 days. Diane Meier in her April 25 2007 CAPC Audioconference on Quality 101 reported a median of 18 days at Mt Sinai (NYC). O'Mahony 2005 JPM 8 (5) 1033-1038 reported a median of 5 days. Penrod (2006 JPM 9 (4) 855-860) reported avg of 14 days. Norton (2007) reported avg of 2 weeks in the MICU in the usual care phase of their intervention study (for those that screened positive for PC appropriateness). So, just plain all over the place, and in general, the delay is longer than most of us want it to be. (See Cassel & Lyckholm editorial in JPM on this, "Rethinking our M.O.", JPM 2007, 10 (3) 649-650). Shameless self-plug!
Regarding the fourth metric, again there is no benchmark but on average I've seen programs report 3-6 days from PC intervention to death or discharge.
Hope this information helps, and again, sorry for not answering this earlier!
- Brian Cassel, VCU Massey Cancer Center PCLC, 804-628-1926, jbcassel@vcu.edu
Thank you again.
Marianne