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The value of the Palliative Performance Scale (PPS)

Dr. Michael Downing, MD (Director of Research at Victoria Hospice, Canada), talks about the advantages of using the Palliative Performance Scale to facilitate communication between professionals. Transcripts parts were taken by interview provided to the Canadian Virtual Hospice, and was released by Creative Commons license.

The Palliative Performance Scale (PPS) has in the last number of years, with the fair amount of research and publications on that, has become a tool that has several values to it. I think it’s most valuable aspect is as a simple communication tool amongst professionals. So, if I am talking with a homecare nurse and she says my patient is at PBS 40%, then I know exactly what functional performance level they’re at. She doesn’t need to explain it to me any more than that. It is an easy tool to assess somebody, it’s very easy and a good uptake in terms of communication, as a communication tool.

PPS could be used for workload assessment. For example, certainly people who are at a PPS of 30% are what we call “totally bed down”, they need a lot of nursing care. Whereas somebody at PPS 40% or 50% may need less nursing care, but they’re at a higher risk of falling and injuring themselves. So, it could be used by palliative programs for workload assessment and measurement.

Because I’ve had a general interest in prognosis over the years, then we began to look at PPS in terms of prognostication. And indeed PPS, as well as the Karnovski and a couple of other performance status tools, do have a predictive ability from a survival viewpoint. And so we have created a number of survival tables.

We published several papers on Its ability to assist in prognostication. It’s not a be-all and end-all, but it is certainly an element of value, and so it’s become much, much more widely used in probably most programs in Canada. I think it’s translated now into several other languages and used in other parts of the world as well. It’s a good tool!

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