Environmental Scan of the Information Transfer Process for Admissions to an Acute Palliative Care Unit in an Academic Cancer Center (QI433)

1. Determine the current methods of information transfer for inpatient admissions in palliative care units 2. Identify what is considered relevant information to provide clinical care from the perspective of palliative care physicians from an acute palliative care unit 3. Reflect in their current transfer of information and strategic points in the admission process where improvements can be made Transfer of information is essential for timely and safe delivery of patient care. Little is known about the standard of information transfer upon admission to an acute palliative care unit (APCU). To improve information transfer upon admission to an APCU at an academic cancer centre, the current state was assessed through staff survey, team communication record audit, and stakeholder interviews. A Likert-scale survey was sent to the palliative care (PC) physicians working on the APCU, and a semistructured interview was conducted to identify their perceptions and satisfaction with clinical information transfer upon admission to the APCU and the relevant information that should be included. The content in the first communication requesting admission from July 28 to October 14, 2020, was analyzed to assess the quality of information transferred. Twelve PC physicians were surveyed; 5 were randomly selected for the interview. From the survey, 50% were satisfied with the current transfer information process, 33% agreed that the information received before admission was complete, and 83% needed to perform additional review to obtain relevant information to provide care, taking up to 30 minutes. The most relevant topics for the PC physicians included goals of care, reason for admission, Palliative Performance Scale (PPS), prognosis, power of attorney for care (POA), family and social information, and proposed disposition. In 41 admission requests, the relevant information included in the initial communications included reason for admission (95%), goals of care (32%), PPS (15%), POA (10%), prognosis (7%), family dynamics (13%), and proposed disposition (46%). The current process of information transfer during admissions to an APCU is suboptimal, and the relevant information included in the initial request is sparse. Using the Plan-Do-Study-Act cycle process, we are developing a tool to improve the transfer of information during admissions.