Background: When faced with a terminal illness, patients’ under hospice services want to know their estimated length of survival. Not knowing leads unrealistic plans of care and unknown life expectancy rates. Foreground: Patients rely on the use of prognostication so that proper planning and discussions of the end-of-life can be had. It is not only the patient who benefits from the use of an accurate prognostic tool but also family, friends, and all involved in the patients’ medical care. Because individuals with a terminal illness need and want an estimated length of survival, having a clinician that is knowledgeable in the accurate use of the Palliative Performance Scale (PPS) will allow for accurate prognostication and open lines of communication. Methods: An RN Case Manager was a strong advocate for this change project. The Palliative Performance Scale was implemented by a multidisciplinary team of stakeholders, including administrators who opposed the project at the beginning. EBP Framework: A conceptual model was used to guide this change process. Lewin’s model of change improved the organizational environment by accessing and addressing barriers to the change process that directly influenced outcomes. The ARCC model assessed an organizational readiness for an EBP change and guided the change project through steps that allowed for EBP implementation and sustainability. Findings/Results: The implementation of the Palliative Performance Scale was funded by the organization at a low-cost, a one-time fee for an educational on-line program that offered instructions on the accurate use of the Palliative Performance Scale and offered 1.2 Continuing Medical Education hours. Education on the accurate use of this prognistic tool has enhanced clinician accuracy rates and improved prognistication for patients’; as evidenced by chart audits over a two month timeframe and an increased understanding of the Palliative Performance Scale as voiced by staff. Conclusion: Frequent monitoring of computerized documentation that reflects clinician accuracy rates in the use of the Palliative Performance Scale will allow for the assessment of retained education and improved prognostication. Monitoring accuracy enhances clinician knowledge and increases accurate estimated survival lengths that promote patient decision making and planning at end-of-life.
