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Triaging the terminally ill—Development of the Responding to Urgency of Need in Palliative Care (RUN-PC) triage tool

Journal of Pain and Symptom Management Sep 20, 2019

Russell B, Vogrin S, Philip J, et al. - In view of the increasing attention towards evidence-based resource allocation to achieve equity, transparency, and cost-effectiveness across healthcare, researchers sought to create the scoring system for the novel Responding to Urgency of Need in Palliative Care triage tool, so that identification of patients with terminal illness who should be prioritized for urgent palliative care could be done. They undertook online international discrete choice experiment involving palliative care clinicians [n = 772; female (79.9%)] with a decade of clinical experience to establish the relative importance of seven key attributes of palliative care triage identified during an earlier qualitative study. The most important determinant of urgency was physical suffering, followed by imminent dying, psychological suffering, caregiver distress, discrepancy between care needs and care arrangements, mismatch between current and desired site of care, and unmet communication needs. This discrete choice experiment made the palliative care triage, which is complex and contextual, more transparent. They identify the Responding to Urgency of Need in Palliative Care triage tool as a significant step toward evidence-based evaluation of priority for palliative care.
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