Beth Israel Medical Center
Department of Pain Medicine and Palliative Care
MINI-VERSION OF THE PROCESS AUDIT
VARIANCE TRACKING: PCAD
© 2000 by Beth Israel Medical Center, Dept. of Pain Medicine and Palliative Care.
Published here with permission.
| Patient Name:__________________________ | PMR #:_________________________________ |
| Date:________________________________ | |
| Repeat for each day on PCAD Care Path. If no provide explanation in Comments section. | |
| Y | N | N/A | Advance directives were discussed and patient/family preferences identified. Comments:
|
| Y | N | N/A | Goals of care were clarified with patient/family. Comments:
|
| Y | N | N/A | Pain and symptoms were adequately managed. Comments:
|
| Y | N | N/A | Supportive interventions and consults were enacted. Comments:
|
| Y | N | N/A | Unnecessary interventions were discontinued and none were ordered. Comments:
|
| Y | N | N/A | Patient/family psychosocial and spiritual support was
provided. Comments:
|
| Y | N | N/A | Unnecessary regulations were eliminated. Comments:
|
| At discharge: | |||
| Y | N | N/A | Bereavement services/resources were
provided. Comments:
|
| Y | N | N/A | Patient was transferred to alternate care
setting (e.g., Hospice, SNF, Home Care, etc.). Comments:
|
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