Evohealth / Transforming Palliative Care: A collaborative approach to enhancing end-of-life support

Transforming Palliative Care: A collaborative approach to enhancing end-of-life support

THE CHALLENGE

Australia faces the challenge of an ageing population, leading to an increased prevalence of cancers and chronic conditions, consequently raising the demand for palliative care services. Murrumbidgee Primary Health Network (MPHN), in regional Australia, recognises palliative care as a crucial health priority. Addressing the need for equitable access to palliative care, particularly in after-hours periods and rural areas, has been a significant concern highlighted in various health assessments and strategies.

THE OUTCOME

Through research, collaboration and evidence-based approaches, Evohealth and MPHN pioneered a model of palliative care, via a practical toolkit. This toolkit addresses critical gaps, ultimately enhancing the quality of palliative care access and delivery in Residential Aged Care Homes (RACH) in the region.

Based on the findings of the evaluation of the toolkit, three recommendations were proposed for future use to further enhance palliative care practices:

  1. Facilitate widespread availability of the toolkit across all RACH within the Murrumbidgee region.
  2. Ensure regular updates of the toolkit to align with regulatory, legislative, and clinical standards, thus maintaining its relevance.
  3. Design tailored implementation plans considering facility maturity and challenges in engaging healthcare professionals, such as GPs and pharmacists, in utilising the toolkit effectively.

OUR APPROACH:

The project was divided into two phases.

Phase 1: Over six months, Evohealth collaborated with MPHN to successfully develop and pilot an evidence-based toolkit to enhance access to palliative care medications access in RACHs. Activities included assessing existing gaps in care, engaging stakeholders, implementing the pilot, and evaluating effectiveness.

The result of Phase 1 was the development of the toolkit, co-designed with regional stakeholders, offering standardised tools and resources for optimal palliative care delivery. While the primary outcome of reducing avoidable hospitalizations wasn’t achieved due to the short implementation period, significant secondary outcomes were realised including improved staff awareness, knowledge, and confidence in administering palliative care medications.

Phase 2: Building upon the success of Phase 1, Phase 2 extended over 13 months and focused on evaluating the implementation of the toolkit over the longer period. Key activities included developing evaluation frameworks, aligning data collection methods with existing reporting structures, providing implementation support, and assessing the effectiveness of the toolkit and implementation strategy.

The evaluation of Phase 2 demonstrated a substantial reduction in hospital transfers for palliative care, emphasising the real-world impact of the toolkit in enhancing preparation and planning for palliative care within RACH in the Murrumbidgee region. Improved awareness, confidence, and governance of palliative care were also reported across all facilities, highlighting the value as a clinical and communication tool.

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