You are here More Pages
Palliative Care Outcomes Collaboration

Assessment tools and forms

PCOC assessment tools

Every patient has the right to effective treatment and management for pain and symptoms. In addition to palliative outcomes and profile programs, PCOC uses five clinical assessment tools to help identify and manage these common symptoms.

PCOC’s model relies on the use of five tools. These five tools help assess the characteristics and needs of patients. All of the tools are validated. They perform well in terms of their measurement properties. They perform well within the clinical settings. They are easy to use as part of routine care. Each tool has been used with hundreds of thousands of patients over the last decade.

 

  1. Palliative Care Phase
  2. Symptom Assessment Scale (SAS)
  3. Palliative Care Problem Severity Scale (PCPSS)
  4. Australia-modified Karnofsky Performance Status (AKPS) Scale
  5. Resource Utilisation Group - Activities of Daily Living (RUG-ADL)

What is the Palliative Care Phase?

The palliative care phase identifies a clinically meaningful period in a patient’s condition. The palliative care phase is determined by a holistic clinical assessment, which considers the needs of the patients and their family and carers. A change in palliative care phase represents a change in the person’s clinical condition and/or a change in the patient’s carers or family. These changes lead to a change in the patient’s care plan. Five palliative care phases (pdf) are possible. A patient may move back and forth between phases. A structured phase algorithm (pdf) can help guide healthcare professionals to determine the correct phase. Palliative care phase has a long history of development (pdf). Its development commenced in the 1990s. The palliative care community has described phase as an important tool. This is because it can help develop a common palliative care language across countries. Phase is used in Australia, Germany, Great Britain, Ireland, Taiwan and Singapore.

 

Key resources:

The PCOC Symptom Assessment Scale (SAS) is a patient-rated tool to measure the amount of distress caused by seven of the most common symptoms in palliative care. Staff need to know how bothered, worried or distressed patients are by each of the symptoms in order to effectively manage what matters to patients. The measure is easy to use and brief. Staff ask patients to rate their distress relating to each of the seven symptoms on a scale from 0 to 10, 0 being distress-free and 10 being severe distress.

 

Key resources:

 Translated SAS form:

The PCPSS is completed by clinicians. PCPSS measures the severity of symptoms. The tool can be used for initial screening, symptom management and ongoing coordination of palliative care. Four palliative care domains are assessed through PCPSS: pain, psychological/spiritual, other symptoms and family/carer. Each domain is rated on a four-point scale with 0=absent, 1 =mild, 2 =moderate and 3 =severe.

Key resources:

The RUG-ADL is a four-item scale. RUG-ADL measures functional status. It measures motor function in relation to activities of daily living (ADL). Four ADLs are examined: bed mobility, toileting, transfers and eating. RUG-ADL helps identify the assistance a patient needs to carry out these ADLs. RUG-ADL helps identify the resources that the patient needs. When assessments are completed, the assessment is based on what the person does, not what they are capable of doing.

Functional status is different to performance in that functional measures examine what the person does, not how they perform. Compared to other tools that measure function, the RUG-ADL is a measure particularly useful in palliative care. This is because ADLs are hierarchical. The RUG-ADL items (e.g. toileting, transfer) are the four items that a patient will lose last as they deteriorate and approach death.

 

Key resources:

The AKPS scale is a measure of the patient’s performance across the dimensions of activity, work and self-care. The AKPS results in a single score between 0 and 100. For PCOC, the scores from 10 through to 100 are reported. AKPS is completed by a clinician. It is based on observations of a patient’s ability to perform common tasks relating to activity, work and self-care.

 

Key resources:

Assessment and Response Protocol

PCOC’s assessment and response protocol provides guidance on how to use PCOC’s tools. The protocol also helps with responding to needs identified in assessments. The differences between anticipatory and responsive care are explained. Assessment and response resources, such as forms and lanyards, are included. Tips on how to embed palliative care assessments and outcomes into routine practice are featured. This includes guidance on how to integrate PCOC into orientation and education procedures within services.

Download PCOC's assessment and response protocol (PDF: 950 KB)

PCOC Programs and Forms

PCOC’S palliative care outcomes program

Two types of forms are available for use in PCOC’s outcomes program:

  1. An easy-to-use form called the PCOC assessment and clinical response form. This form contains PCOC’s validated measures, and prompts to aid a clinical response. You can use these forms depending on whether it is a SAS first of Phase first assessment. Download the PCOC Assessment and Clinical Response form_SAS first (docx) and PCOC Assessment and Clinical Response form_Phase first (docx)
  2. A brief form to capture patient’s details. This includes episodes of care. Three versions of this form are available. The version to use depends on the setting of care and model of palliative care being provided.