18th November 2017


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SKIPP- A NEW OUTCOME MEASURE FOR PALLIATIVE CARE

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Dr Nigel Sykes, Consultant in Palliative Medicine, Medical Director
St Christopher’s Hospice, London SE26 6DZ

Rosanna Heal, Quality Manager
St Christopher’s Hospice, London SE26 6DZ

SKIPP (St Christopher’s Index of Patient Priorities) is a new outcome evaluation tool for use with palliative care patients. It explores patients’ perceptions of their quality of life, pain, depression and other key problems and what effect the care given has had on all these issues.  Developed by Professor Julia Addington-Hall in collaboration with St Christopher’s Hospice in London, SKIPP has eleven questions, most answered by tick boxes. It can be completed either by patients themselves or by a member of staff on their behalf. There are versions for use in the inpatient unit, in the community and in day care. Significantly it asks about how the patient is feeling now and also asks them to recall how they were feeling at a certain point prior to entering the Hospice’s care. From a single use it therefore compares symptoms at two time points, overcoming the well-known problem of response shift. This is where, for example, a patient may rate their pain as ‘very severe’ until they develop a new pain that is even worse. Repeating the pain assessment will still give a rating of ‘very severe’ as if no change had taken place, but in fact the patient’s pain experience has deteriorated in the interim. Another important advantage of this tool is its brevity- many palliative care patients are too ill to cope with longer questionnaires.

Although SKIPP is informed by the principles of patient-generated quality of life measurement, it is not intended that it should be a measure of an underlying concept of ‘quality of life’ or ‘health-related quality of life’, nor that it should be a comprehensive inventory of palliative care outcomes.  Instead, the emphasis is on detecting whether and in what ways the service using the measure is impacting on the lives of patients receiving its care, from their perspective.

SKIPP provides a validated and sensitive method of assessing patient outcomes in palliative care and demonstrates the contribution that a service has made to the wellbeing of both these groups.It is hoped that in time the use of these instruments will extend across hospices and many other organisations delivering end of life care, giving opportunities for benchmarking.

Contact for further information: Rosanna Heal, Quality Manager, St Christopher’s Hospice, Lawrie Park Road, London SE26 6DZ: r.heal@stchristophers.org.uk

  

CME McKinley (c) 2010 Independent Association of Nurses in Palliative Care