The utility of the “consideRATE” patient-reported experience measure in hospital patients receiving specialist palliative care: a two-phase prospective pilot study
TL;DR
Supporting administration of consideRATE in a specialist palliative care unit and consultative service resulted in high participation and completion rates with no reported distress among participating patients and carers, and staff considered the measure appropriate and perceived the data as useful for informing quality improvement.
Abstract
Background Patient-reported experience measures (PREMs) are increasingly central to ensuring healthcare quality. Uncertainty about the utility of PREMs for hospital patients with palliative care needs has limited their use in this population. Aim To determine the utility (feasibility, acceptability, and appropriateness) of implementing the PREM “consideRATE” for patients receiving specialist palliative care and to explore its perceived value for quality improvement. Design A two-phase prospective pilot study incorporating PREM administration, screening logs and field notes, and focus groups. Setting/participants The study was conducted in a specialist palliative care unit and consultative service in a metropolitan Australian hospital. Participants were recruited by research staff and included adult inpatients receiving specialist palliative care or their carers (PREM completion and feedback) and multidisciplinary staff (clinicians, managers, and quality and governance personnel) (focus groups). Results Across 219 eligible participation occasions, 188 PREMs were completed (86% participation rate). No patient or carer distress was reported during PREM administration, and occasional spontaneous comments recorded in field notes indicated appreciation for the opportunity to provide feedback. Staff participants viewed consideRATE as meaningful and actionable, and perceived that the data could support the identification of improvement priorities and advocacy for system change. They also stated that administration support was essential and that routine implementation of consideRATE was not feasible within existing clinical workloads. Conclusions Supported administration of consideRATE in a specialist palliative care unit and consultative service resulted in high participation and completion rates with no reported distress among participating patients and carers. Staff considered the measure appropriate and perceived the data as useful for informing quality improvement, but concluded that sustainable routine implementation would require dedicated human resources and integration into the hospital's quality systems.