Background and aims: The core documentation is an ongoing quality assurance project in German palliative care units since 1999. Main aim is to give information on quality of structure, progress (diagnostic and therapeutic measures) and outcome. In the first years only objective data were collected, in 2001 a self-assessment for patients was offered as well. In 2002 oncology and geriatric units as well as hospices were invited to take part.
Methods: In 2002 the German version of the Palliative Care Outcome Scale (POS) was added to the core documentation. POS was assessed by staff at time of admission, on day 4 after admission, weekly thereafter and at time of discharge. Self-assessment was offered to patients at the same times as for staff. If patients were not able to answer the questionnaire help was offered from relatives or the team.
Results: Sixty-nine centres included 1546 patients with 5020 assessments. The POS was used by staff 4911 times and by patients 2208 times. In 2090 times self-assessment was not possible mainly because of weakness (42%), cognitive impairment (26%), refusal of the patient to take part (15%) and lack of time (7%). The mean of POS global scores was 13 (max. 40). The mean scores for staff-assessment during the stay were 14.9 at admission, 13.7 on day 4, 12.9 on day 7 and 12.6 on discharge. Assessment of staff was on average slightly higher than for patients with mean scores of 16.1 at admission, 12.8 at day 4, 12.1 at day 7 and 10.1 on discharge. The correlation of global scores between staff and patients was high. However, the participating units gave feedback that the POS was to complicated and time-consuming to be part of routine documentation.
Conclusions: The POS is now a widely used assessment tool in palliative care in the UK. AGerman POS version was added to the core documentation for German palliative care units with a compulsory part for staff assessment and an optional part for patient assessment.