PPF58 The comfort tracker – a novel approach to symptom management and support for patients and carers with palliative and end of life care needs

<h3>Background</h3> Digital technology has the potential to improve timely healthcare provision and effectiveness and improve patient and carer experiences. Community nursing and palliative care services are likely to be overwhelmed in the coming years. To address an increasing number of patients with palliative and end of life care (PEOLC) needs alongside an increasingly stretched workforce, we have explored use of digital technology to enhance support available for patients at home in their last 12months until death. <h3>Method</h3> User engagement was followed by clinical pathway review, information development, subsequent work up of technical delivery with virtual health platform Doccla, to create the Comfort TrackerTM(CT) - an app which enables patients to document symptoms and wellbeing and review initial self-management advice. The CT uses the IPOS questionnaire. Scores are relayed to a digital dashboard monitored by community nursing teams. The nursing teams track the trajectory of decline of the patients and interact via telephone, video or visits depending on need. Using PDSA (Plan Do Study Act) methodology the CT was used by 11 community nursing teams pan-Sussex. <h3>Results</h3> Results of the 6-month PDSA will be available by the Conference. Provisional feedback from the first 50 participants is positive: EG 1: some patients needing bi-weekly visits from community nursing were so reassured by the CT that it replaced physical visits; EG 2: patients received earlier care input based on symptoms - thrush identified and treated. Carer wellbeing is also tracked. Acceptability and usability, as well as admission avoidance and healthcare professional utilisation and reduction in moral distress are KPIs. <h3>Conclusion</h3> The Comfort Tracker app has the ability to revolutionise support available to patients in the last year of life. Initial PDSA focussed on support for patients at home via community nursing teams, care home and hospice expansion is planned.