PPF65 Implementing the regular use of the integrated palliative care outcome scale (IPOS) at a specialist palliative care unit. A quality improvement project

<h3>Background</h3> IPOS is a validated, multidimensional outcome measure designed to capture patients’ symptoms, concerns, and priorities in palliative care. It can be completed by patients, carers, or healthcare professionals, allowing flexibility for those too unwell to self-report. Routine IPOS use supports longitudinal symptom monitoring, care planning, and timely clinical intervention. Without national standards, IPOS completion at the specialist palliative care unit in Beccles was inconsistent and poorly embedded. A Quality Improvement programme aimed to raise completion to 80% and address barriers to sustainable implementation. <h3>Methods</h3> A Plan–Do–Study–Act (PDSA) methodology was applied to all inpatient admissions. Monthly retrospective data were extracted from SystmOne and validated against admission records then manually collated and analysed using run charts. The primary outcome was the proportion of patients with at least one documented IPOS during their admission, with secondary measures capturing patients deemed not appropriate or who declined participation. Barriers and enablers to completion were identified using stakeholder analysis and a driver diagram, guiding targeted interventions such as staff education, workflow integration, induction, and appointment of an IPOS coordinator. <h3>Results</h3> Baseline IPOS compliance was 28% however following sequential PDSA cycles, a sustained improvement was observed with compliance increasing to approximately 50–55%. Completion was highest when IPOS was embedded into admission processes and routine handover documentation. Missed IPOS completion was most commonly associated with short admissions ending in death and failure to document patients as ‘not appropriate,’ resulting in underestimation of true compliance. <h3>Conclusion</h3> Embedding IPOS into routine clinical workflow was associated with improved completion rates, although the target compliance of 80% was not achieved. Education alone was insufficient; workflow integration, clear ownership, and admission-day completion were key enablers. Accurate documentation of patients unsuitable for IPOS is essential for meaningful interpretation of compliance data. This approach is transferable to other hospice inpatient and community palliative care settings.