100 How effectively does a specialist palliative care service identify key elements of a palliative care consultation? A documentation audit

<h3>Background</h3> The Comprehensive Geriatric Assessment (CGA) is a standard assessment in frail people leading to better care and outcomes for patients and families. A Comprehensive Palliative Care Assessment (CPCA) has never been defined or validated in the same way. There is current evidence available indicating the domains that should be included.The aim was to audit how effectively a hospice community team identify the core components of a CPCA. <h3>Method</h3> A literature review in October 2021 (updated September 2024) identified the current evidence base regarding palliative care assessments. A multi-disciplinary group reviewed and agreed domains and sub-domains for a CPCA. The domains were; physical, psychological, social, spiritual and advance care planning (ACP). These established audit standards. Randomly identified 27 assessments were tested against the audit standard. <h3>Results</h3> The majority of sub-domains were identified (table 1). Physical sub-domains were most common but least likely to be addressed, although the rate addressed was still high. Spiritual needs were rarely identified but were all addressed. The psychological sub-domain of ‘mental health’ and social sub-domain of ‘beliefs, attitudes and resilience’ was not identified in any of the patient assessments. Sub-domains identified but not addressed occurred in only 2 patient assessments, which may have been assessor related or due to tensions within the consultation. All ACP sub-domains were identified but 30% of patients declined an in-depth discussion. The only assessment tools used were: Integrated Palliative care Outcome Scale (IPOS), Phase of Illness and Australian Karnofsky Performance Scale (AKPS). <h3>Conclusion</h3> Overall, core elements of a CPCA were identified and addressed during assessments. Assessment tool use was limited. Further work is needed to identify an effective, evidenced based CPCA that takes into account the core domains. It should focus on how the consultation is undertaken. A palliative care assessment should not be a tick box exercise.