Introduction: Triage, widely used by the military and emergency departments, has not been reported in community palliative care services. Policy designed to improve equitable provision of this care has led to the development of a triage tool. Methods: Retrospective data were collected (50 percent of referrals, n=204) and analyzed using the Wilcoxon signed-rank test to determine the accuracy of the tool in predicting patient status at the first visit. Semi-structured interviews (n=7) with palliative care service staff added qualitative data. Results: Although significant differences between triage scores compared to outcomes at first visit were observed, issues such as upgrading of triage category compared to priority score occurred in more than 30 percent of cases. When correction for this was made, the tool was found to be an accurate guide to patient needs. Conclusion: This tool, when used as intended, was effective in assessing the urgency of need, and it is potentially useful on a wider scale, subject to further evaluation.

Little has been reported regarding the nature of home visits by palliative care specialist physicians to assist in the management of complex cases. We determined the characteristics, actionable clinical findings and recommendations made during consecutive home visits conducted by a specialist physician for patients registered with a community palliative care service. Patient demographic information and clinical records were reviewed. Ninety-one patients received a total of 104 home and residential facility visits. Median patient age was 59 (Q1-Q3, 43-72). Ten children (under the age of 14) received a total of 15 visits. Seventy-three patients (80%) had a cancer diagnosis. Median visit duration was 60 min (Q1-Q3, 45-60). The major actionable clinical findings were pain (120), gastrointestinal (115), neuropsychiatric (58), mouth and skin (33) and respiratory (29). One-third of recommendations involved changes in analgesia regimen (opioids 67, adjuvants 44). The specialist physician home visit resulted in multiple patient care recommendations. This information may help palliative care programmes improve their care for patients and families in the community.

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