119 A retrospective audit of the palliative care team electronic mdt proforma at the royal marsden nhs foundation trust

Background The Palliative Care (PC) Multidisciplinary Team (MDT) in a tertiary referral oncology hospital meets weekly across two sites. All new referrals and all inpatients under the PC team are discussed. In June 2016 an electronic MDT (eMDT) proforma was developed to record data including performance status, phase of illness, estimated prognosis, spiritual, psychological and welfare needs and Urgent Care Planning. A weekly MDT register is taken to establish core membership attendance and adherence to recommendations in the National Cancer Peer Review Programme (2012). A retrospective audit of the data was conducted. Methods Weekly eMDT data (1 st June 2016 – 31 st March 2017) and PC inpatient lists were reviewed. All patient discussions were retrospectively analysed to determine whether we were achieving departmental standards. Microsoft Excel was used for statistical analysis. An audit standard of 75% was set for core MDT attendance and for recording all data. Results 803 individual patient discussions took place. 75% core attendance was achieved. Psychological needs were documented on the e-MDT form in only 38.5% and PPD in 25.7% overall. 67 (8.3%) of patients had an initial prognosis of ‘hours to days’ when first discussed. Of these 54 (81%) had a documented preferred place of care (PPC) and 52 (78%) had a documented preferred place of death (PPD). Conclusions Electronic documentation of palliative care MDT discussions and decisions facilitates analysis and quality improvement. On the basis of this audit the operational policy has been updated. The psychology team have been invited to join the weekly MDT. The audit standards regarding PPD have been amended to only include patients who are identified as dying.