Abstract:
The first assessment for a hospice service is complex and multidimensional. It takes
place during a process of transition to palliative care, and involves assessment of
need, clinical judgment, informed choice, decision-making and care planning. It is
more than a technical event; it is a process of building a relationship between a person
and the assessor. This relationship is a catalyst, promoting an environment of support,
to facilitate the planning of care and services for people facing the end of life.
Mary Potter Hospice works in close partnership with the Care Co-ordination Centre to
provide a community based specialist hospice palliative care service on behalf of the
Capital and Coast District Health Board. Palliative Care Co-ordinators, employed by
Mary Potter Hospice, are responsible for conducting the first assessment for people
accessing hospice care. This can require an additional community package of care to
meet their complex needs and referrals between the two services regularly take place.
The two services currently use different assessment processes, and information cannot
be easily shared. This can result in duplication and repetition. The Care Co-ordination
Centre uses a Resident Assessment Instrument (RAI) as their assessment tool. It is
anticipated a palliative care version of the tool (the RAI-PC) will enhance the
assessment and decision-making process, improve access to services, improve
communication between the two services, and improve management processes.
This paper presents the findings of a research project, which explored the use of an
electronic assessment tool for a hospice service in New Zealand. It is written from the
perspective of an expert palliative care nurse, informed by a review of current policy
and process, the practice and views of hospice colleagues, and a literature search. The
findings indicate a number of potential benefits for people, clinicians and
management. However, there are associated risks and recommendations are made to
guide an implementation process. In the absence of experience, or evidence, within
New Zealand this research will start to inform hospice and palliative care colleagues
on the potential of the RAI-PC for the first assessment process for a hospice service.
