Improving access to resources for acute care health professionals
A post written by Dr. Deborah van Gaans
Collaboration with the acute care sector has directed the development of palliative care resources to guide, assess and respond to patient needs.
Currently, acute hospitals provide end-of-life care to most people who die in Australia, and this is likely to increase in the future in response to Australia’s growing ageing population. [1] While there has been considerable investment in services, palliative care guidelines, education programs, advanced care planning programs, care pathways, and frameworks, there are persistent gaps in the quality and safety of end-of-life care. [1] Therefore, it is important to provide health professionals working within the acute care setting with current evidence-based information and resources to aid in the provision of best quality palliative and care at the end-of-life.
Gaps in care provision at end-of-life within the hospital setting in Australia have been recently reviewed and include the following multiple issues:
- Timely and culturally appropriate communication with the patient and family
- Standardisation of documentation to support patient and family preferences
- Good interdisciplinary teamwork and care coordination
- Identification of goals of care
- Embedding of guidelines and triggers into routine care
- Developing processes to identify deteriorating patients
- Organisational readiness to implement a personalised and compassionate approach to care. [2]
In May 2021 the Australian Commission on Safety and Quality in Health Care released “Delivering and Supporting Comprehensive End-of-life Care: A User Guide”.[3] The guide provides strategies and suggested practice for end-of-life care that health services and clinicians can utilise to meet the essential elements of safe and high-quality end-of-life care and the National Safety and Quality Health Service (NSQHS) Standards (second edition) requirements.[3] CareSearch used the guide and a scan of recent evidence as a basis to begin development on a new section of webpages aimed at providing evidence-based resources to guide, assess and respond to patient needs within the Australian acute care setting. To ensure that the resources were relevant and actionable, CareSearch collaborated with a range of acute care clinicians, policy leaders, and researchers. Through the co-design of the new Acute Care Section within the CareSearch Information Portal, gaps in the provision of end-of-life care have been addressed through the creation of the following webpages:
- Palliative care within the acute care setting
Palliative care is an integral part of hospital-based care requiring recognition of the complex care needs of patients including in the transition from curative to palliative care. We provide access to key guidelines that define and guide palliative care, and care at the end of life within the Australian acute care setting.
- Planning for palliative care delivery
Highlights several models, pathways, and frameworks currently used within the acute care setting to guide in-hospital care including transitions between hospital units, and transition to external settings such as home or aged care.
- Recognising the need for palliative care
Tools and information on how to recognise the need for palliative care.
- Communication and shared decision-making
Information and resources for effective communication and shared decision-making to ensure patients and their family are informed and included.
- Responding to patient needs
Evidence-based resources to aid in responding to patient needs as their physical, psychosocial, cultural, and spiritual care needs change over time.
Knowing who can assist either directly or via eHealth, and managing referrals can contribute to optimal patient care.
- Patient transitions and coordination of care
Health professionals need information and resources to support the movement of patients along their care pathway.
Information and resources that health professionals can use to provide grief and bereavement care to families and carers.
Online education opportunities for professional development in palliative care, and care at end-of-life that is tailored to health professionals working within the acute care setting.
This new section within the CareSearch Information Portal, provides a single access point to actionable evidence-based resources specifically tailored for health professionals working within the Australian acute care setting. The co-design of these webpages with representatives of the acute care sector have ensured that the content is well aligned with the needs of acute care health professionals. As the World Health Organization recently identified, national policies, programmes, resources, and training on palliative care among health professionals are urgently needed in order to improve access to palliative care. [4]
References
- Australian Commission on Safety and Quality in Health Care (ACSQHC). Safety and Quality of End-of-life Care in Acute Hospitals: A Background Paper. Sydney: ACSQHC; 2013.
- Rawlings D, Devery K, Tieman J, Tait P, Chakraborty A. Rapid Review of the Literature on End-of-Life Care. Sydney: ACSQHC; 2021.
- Australian Commission on Safety and Quality in Health Care (ACSQHC). Delivering and Supporting Comprehensive End-of-life Care: A User Guide. Sydney: ACSQHC; 2021.
- World Health Organization (WHO). Palliative Care [Internet]. Geneva, CH: WHO; 2020 [updated 2020 Aug 5; cited 2022 Nov 29].
Dr. Deborah van Gaans
Research Associate
CareSearch
College of Nursing & Health Sciences
Flinders University