Classification systems can be useful tools for reducing a complex disease/condition into identifiable elements, and a means to communicate these between professionals. These systems may be used to define, usually in terms of severity, specific aspects of diseases and conditions. They may also be used to classify predisposition to specific conditions, for example the risk of pressure ulceration. Information generated is used to guide treatment and care planning, and to predict outcomes. Classification systems can become lengthy and complicated in the process of trying to represent the complex disease process/condition, or they are a simplification. Both these limitations may be particularly important in the specialty of palliative care where the advanced nature of patients’ conditions often results in multiple overlapping disease, treatment and individual variables. The successful use of classification systems in clinical decision-making requires valid and practical systems to be used alongside sound clinical knowledge. A novel approach that combines classification, care planning and treatment evaluation is a clinical note-making system, TELER®. This system includes patients’ goals, theoretical and clinical knowledge, and uniquely measures how patients’ problems change with treatment and care. The system can incorporate validated classification systems, for example the World Health Organisation analgesic ladder for cancer pain relief. In this paper the system is presented as a tool that has been applied to decision-making and evaluation in relation to the discrete elements of palliating wounds, in the context of total patient care.