Registry Metrics & Definitions
- Palliative Care Service Penetration
Definition: Percentage of annual hospital admissions seen by the palliative care team. Palliative care service penetration is an estimate of how well programs are reaching patients in need.
Calculation: (Total Initial Palliative Care Consults / Total Hospital Admissions) * 100
Example: Your palliative care program provided 500 initial consults and your hospital had 10,000 admissions during the course of one year.
(500 initial consults / 10,000 annual hospital admissions) * 100 = 5.0% palliative care service penetration
- Interdisciplinary Team (IDT)
Definition: Standards set by the Joint Commission’s Advanced Certification Program for Palliative Care require that a palliative care interdisciplinary team (IDT) include, at minimum, a physician, an advanced practice or other registered nurse, a social worker, and a chaplain. While other members of the palliative care team, such as pharmacists, child life specialists, administrators, and support staff, are important to the palliative care program, they are not included in the core interdisciplinary team.
Citation: Joint Commission on Accreditation of Healthcare Organizations: Revisions to Advanced Certification for Palliative Care Requirements. Jt Comm Perspect 2015;35:11-16.
- Full Time Equivalent (FTE)
Definition: The full time equivalent or FTE is the percentage of time (as a decimal) that a team member dedicates to direct patient care as part of the palliative care service.
Calculation: For each staff person, divide their average weekly work hours by 40 hours (or your standard workweek hours).
Example: A full time staff member represents 1.0 FTE. A staff member who works 25 hours per week (on a standard 40 hour workweek) represents 0.6 FTE.
(25 hours per week / 40 hours in the workweek) = 0.6 FTE
- Total Interdisciplinary Team Full Time Equivalent (IDT FTE)
Definition: The total percentage of time (as a decimal) that the interdisciplinary team dedicates to the palliative care service.
Calculation: For each staff person, divide their average weekly work hours by 40 hours (or your standard workweek hours). Add the FTEs for each discipline to get total FTE for that discipline. Add all disciplines in the interdisciplinary team to get the total interdisciplinary team FTE. The final FTE should be less than or equal to the total head count for your interdisciplinary team.
Example: Your palliative care team consists of 2 Physicians that each work half-time (0.5 FTE + 0.5 FTE = 1.0 FTE Physician), 1 Advanced Practice Registered Nurse that works half time (0.5 FTE APRN), 1 Registered Nurse that works full time (1.0 FTE RN), 3 Social Workers where two work full time and one works half time (1.0 + 1.0 + 0.5 = 2.5 FTE SW) and your team does not have a chaplain.
1.0 Physician + 0.5 APRN + 1.0 RN + 2.5 SW + 0.0 Chaplain = 5.0 Total Interdisciplinary Team FTE
- Interdisciplinary Team FTE per 10,000 Hospital Admissions
Definition: Ratio of hospital palliative care interdisciplinary team staffing FTE per 10,000 hospital admissions. This metric standardizes your staffing to show what your staffing would be if your hospital saw 10,000 admissions. This metric makes it easier to compare your staffing to the staffing at other programs.
Calculation: (Total Interdisciplinary Team FTE * 10,000) / Total Annual Hospital Admissions
Example: Your team consists of 1.0 FTE Physician, 2.5 FTE APRN, 1.0 Chaplain, 2.0 SW and 1.5 RN to total an interdisciplinary team FTE of 8.0 and your hospital had 7,500 annual hospital admissions.
(8.0 FTE * 10,000) / 7,500 hospital admissions = 10.6 interdisciplinary team FTE per 10,000 hospital admissions
- Workload: Interdisciplinary Team
Definition: Workload is the ratio of initial inpatient consults to total interdisciplinary team FTE.
Calculation: Total Initial Consults / Total Interdisciplinary Team Full Time Equivalent
Example: Your palliative care team provided 1,000 annual initial consults and your team consists of 1.0 FTE Physician, 2.5 FTE APRN, 1.0 Chaplain, 2.0 SW and 1.5 RN to total an interdisciplinary team of 8.0 FTE.
(1,000 initial consults / 8.0 IDT FTE) = workload of 125 initial consults per interdisciplinary palliative care team member
- Workload: Provider (Physician or APRN)
Definition: Workload is the ratio of initial inpatient consults to the provider (Physician or APRN) full time equivalent.
Calculation: Total Annual Initial Consults / Total Provider FTE
Example: Your palliative care team provided 1,000 annual initial consults and had1.0 FTE Physician and 2.5 FTE APRNs for a total 3.5 FTE provider.
1,000 initial consults / 3.5 provider FTE = workload of 285.7 initial consults per provider
- Length of Stay
Pre-Consult Length of Stay: The number of days from admission to initial palliative care consultation. This may also be referred to as “time to consult”.
Post-Consult Length of Stay: The number of days from palliative care consultation to hospital discharge.
Overall Length of Stay: Duration of a single episode of hospitalization from patient admission to discharge (measured in days).
Example: On average, palliative care patients received their palliative care consultation 2.5 days after being admitted to the hospital. These patients spent an additional 4.5 days in the hospital following their palliative care consult before being discharged. Your palliative care program’s time to consult is 2.5 days and your post-consult length of stay if 4.5 days, which totals to an overall length of stay of 7 days.
- Total Palliative Care Encounters
Definition: The total number of visits with a patient during a single admission, including the initial consult and all subsequent visits during the admission.
Calculation: Total Subsequent Visits + 1
Example: For one patient, the palliative care team provided 4 follow-up visits. The total number of encounters for this patient is 1 initial consult + 4 follow up visits = 5 total encounters. In the aggregate, the palliative care team provided 1,000 annual initial consults and a total of 5,000 follow up visits. Overall, the palliative care team had 1,000 initial consults + 5,000 follow up visits = 6,000 total encounters with palliative care patients.
- Percentage of Hospital Deaths
Definition: The percentage of patients who received a palliative care consult during their admission and died in the hospital compared to the total number of hospital deaths for the year.
Calculation: Count of Palliative Care Patients Discharged Deceased / Total Annual Hospital Deaths
Example: There were 1,000 annual discharges from the palliative care program and of those 300 were discharged deceased. During that same time period, there were 900 annual hospital deaths
(300 palliative care deaths / 900 hospital deaths) * 100 = 33%. The palliative care team saw one-third of all annual hospital deaths.