The SARP (Seniority, Acuity, Risk, Political Significance) Method can be used to help triage admissions into a hospice. The goal is for the process to appear fair, rational and consistent rather than arbitrary. The author is from the Hospice of Central New York.
Parameters:
(1) seniority = length of time the case has been ready for admission (length of time on the eligibility list)
(2) acuity = either (a) severity of the patient's symptoms or (b) patient's relative imminence or nearness to death
(3) risk = either (a) current level of family stress or (b) severity of threats to the patient's safety and well-being
(4) political significance = negative impact if a given case is not given priority attention
|
Parameter |
Finding |
Points |
|
seniority on waiting list |
low (short term) |
1 |
|
|
intermediate |
2 |
|
|
high (long term) |
3 |
|
severity of symptoms |
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
nearness to death |
not expected in near term |
1 |
|
|
deteriorating |
2 |
|
|
imminent |
3 |
|
family stress |
low |
1 |
|
|
moderate |
2 |
|
|
high |
3 |
|
threat to patient safety |
low risk |
1 |
|
|
moderate risk |
2 |
|
|
high risk |
3 |
|
political significance |
low risk |
1 |
|
|
moderate risk |
2 |
|
|
high risk |
3 |
SARP score =
= (points for seniority) + MAX((points for symptom severity), (points for nearness to death)) + MAX((points for family stress), (points for threats to safety)) + (points for political significance)
where:
• For acuity and risk I will score both options in each parameter and use the maximum value in the final score.
Interpretation:
• minimum score: 4
• maximum score: 12
• The higher the score the greater the priority for hospice admission.
Purpose: To use the SARP (seniority, acuity, risk, political significance) method to help triage patients for hospice admission.
Objective: severity, prognosis, stage, end-of-life, palliative care
ICD-10: ,
