Mapping Out Your Palliative Patients' Needs: A Triage Tool (FR455)

Abstract

•Describe the dilemma of balancing team bandwidth and patient needs across loci of care.•Apply strategies to determine patient needs and communicate this across palliative care team.•Analyze a tool-based approach to triaging patients in a systematic approach. Pediatric palliative care (PPC) has developed significantly over the past decades. As buy-in increases and PPC is more integrated into different specialties, teams may experience overwhelming growth. While positive, substantial progress can also be a stressor in a field with already high rates of professional burnout. With often limited staffing relative to growth in patient volume, an additional challenge for a palliative care team may be developing ways to ensure patient's palliative needs are met while preserving self-care and team wellness. Triaging acuity for patients based on risk and need becomes important in promoting workflow efficiency and effectiveness. This identification can help empower teams to recognize high acuity patients requiring intense palliative care, while also allowing them to efficiently identify and follow chronic patients with less acuity. Additionally, this process can be adapted across multiple loci of care including inpatient, outpatient, and home based programs with the goal of promoting the provision of high quality care when staffing models may vary. Recognizing this challenge, our PPC team developed a standardized tool to help identify and triage patient needs factoring in acuity both in psychosocial and clinical contexts. This tool has been individualized both for inpatient and home based palliative care teams to describe how often patients warrant a visit and how to identify our highest acuity patients. Our discussion will include our program's experience as well as current literature on the subject. Additionally, we will explore our program's tool and how this can be adapted across loci of care to meet a diversity of patient needs within most palliative care settings. Resources will be provided and discussed for those interested in pursuing similar at their institution.