Adjustment and preliminary application of a data-driven palliative care outcomes collaboration model

doi:10.3761/j.issn.0254-1769.2025.18.002

Abstract

Abstract:

Objective This study aimed to adapt the data-driven Palliative Care Outcomes Collaboration（PCOC） model to the local context and evaluate its feasibility and preliminary effectiveness in a palliative care unit in China，with the goal of informing its broader integration into national palliative care practice. Methods Based on international experience，a localized implementation protocol for the PCOC model was developed through expert consultations and a pilot study. The protocol incorporated key elements including organizational and managerial support，team training and capacity building，information system integration，supervision and feedback mechanisms，process optimization，and data-driven decision-making. From June to December 2023，the protocol was piloted in the palliative care unit of a tertiary cancer hospital in Changsha，China. Implementation outcomes were assessed by comparing patients’ urgent care response rates，symptom stability rates，and symptom improvement rates between the first 1~3 months and 4~6 months after implementation. Results During the study period，a total of 355 inpatients were enrolled，with the PCOC assessment achieving full coverage（100%） and a completion rate of 97.78%. There was no statistically significant difference in the urgent needs response rate between the first 1~3 months and the 4~6 months after the implementation of the PCOC model（P=0.533）. However，compared to the first 1~3 months after implementation，patients in the 4~6 months period showed significantly higher symptom stability rates for pain，psychological/spiritual issues，and family/caregiver problems，as well as a higher improvement rate for pain（P<0.05）. Conclusion The localized PCOC implementation protocol facilitates standardized assessment and symptom management，and its application can enhance the quality of palliative care.

Key words: Palliative Care, Person-Centered Outcome Measurements, Collaboration Model, Data-Driven, Nursing Administration Research

摘要：

目的对数据驱动的安宁疗护协作（palliative care outcomes collaboration，PCOC）模式进行本土化调试，并评估其可行性与初步应用效果，以推动该模式在国内安宁疗护中的实施。方法借鉴国外实施经验，通过专家会议、预试验等确定PCOC模式本土化实施方案，包括组织与管理支持、团队培训与能力建设、信息系统支持、监督与反馈、流程优化与数据驱动等内容。于2023年6—12月在长沙市某三级甲等肿瘤专科医院安宁疗护病区进行初步应用，收集PCOC模式的实施情况，并比较PCOC模式实施后第1~3个月与第4~6个月的患者紧急需求响应率、症状稳定率及改善率。结果研究期间共收治355例住院患者，PCOC模式的覆盖率为100%，评估执行率为97.78%。与PCOC模式实施后第1~3个月比较，实施后第4~6个月患者疼痛、精神/心理问题、家属/照顾者问题的症状稳定率以及疼痛的改善率较高，差异具有统计学意义（P<0.05）；患者紧急需求响应率比较，差异无统计学意义（P=0.533）。结论 PCOC模式本土化实施方案可为标准化评估与症状管理提供支持，采用该模式有助于改善患者的照护质量。

关键词: 安宁疗护, 患者结局指标, 协作模式, 数据驱动, 护理管理研究

CHEN Yongyi, GUO Junchen, DING Jinfeng, SHEN Boyong, WANG Ying, ZHOU Zhiguo, ZHANG Qinghui, LI Liqun, LIANG Feng, David HOLLOWAY, Claire JOHNSON, DAI Yunyun. Adjustment and preliminary application of a data-driven palliative care outcomes collaboration model[J]. Chinese Journal of Nursing, 2025, 60(18): 2185-2190.

谌永毅, 郭俊晨, 丁金锋, 沈波涌, 王英, 周志国, 张清慧, 李立群, 梁凤, David HOLLOWAY, Claire JOHNSON, 戴云云. 数据驱动的安宁疗护协作模式调试及初步应用研究[J]. 中华护理杂志, 2025, 60(18): 2185-2190.

Figures/Tables 4

Table 1 Final localized implementation protocol for the PCOC model

Table 2 Comparison of patient characteristics between the first 1-3 months and 4-6 months after PCOC implementation

Table 3 Symptom stability comparison between the first 1-3 months and 4-6 months after PCOC implementation（percentage，%）

Table 4 Symptom improvement comparison between the first 1-3 months and 4-6 months after PCOC implementation（percentage，%）

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