End-of-life essentials: education for allied health professionals

Kim Devery1, Jennifer Tieman2

1Palliative and Supportive Services, School of Health Science, Flinders University, GPO Box 2100 Adelaide, 5001. Kim.devery@flinders.edu.au
2Palliative and Supportive Services, School of Health Science, Flinders University, GPO Box 2100 Adelaide, 5001.

Background

Many allied health professionals will find they are providing services and care for Australians who are in the last year of life with little training on end-of-life issues.   The majority of Australians will die in acute hospitals. Common challenges for any clinician include:

  • Not knowing how to respond to patient questions ‘such as am I dying?’ or ‘what will happen to me?’
  • Being able to recognise and understand dying patterns
  • Negotiating goals of care with patients, families and other professionals
  • Working effectively in a team
  • Knowing what to do if patient suffering persists

Methods

The End-of-life Essentials project provides free e-learning modules and implementation resources for hospital clinicians. Designed for nurses, doctors and allied health professions working in any acute care practice setting, these modules provide specialist e-learning and resources to increase knowledge in end-of-life care. The package has been prepared by the palliative care team at Flinders University in partnership with the Australian Commission on Safety and Quality in Health Care. The resources and e-learning are free to use and can be easily accessed from anywhere in Australia.

Discussion

Dying is a normal part of life and a human experience.  Access to appropriate and specialist e-learning and resources will empower and enhance allied health professions to confidently respond to and manage challenging end-of-life care.

End-of-Life Essentials Team

Biography

Kim Devery coordinates the palliative care post graduate programs at Flinders University South Australia. She also leads a national project which aims to increase the knowledge and skill capacity on end-of-life care for health care professionals.

Auditing: Death by a thousand paper cuts or the unheard client voice?

Lisa Furness

1Country Health SA Local Heath Network, PO Box 287, Rundle Mall, Adelaide, 5000.   lisa.furness2@sa.gov.au

Clinical auditing has long been utilised by health organisations as a tool for quality review in an integrated clinical governance framework.  Anecdotally auditing can suffer from an image problem amongst clinicians, despite widespread acknowledgement of usefulness in the quality system. This may include perceptions that auditing is a dry, highly intensive, “big brother”, detail driven review process that takes away precious time from direct client services in already stretched and busy teams. Auditing can be seen as an additional impost rather than a core professional activity.

This presentation serves to explore an alternative way to consider and manage attitudes towards auditing; to facilitate a shift from auditing being considered an onerous quality process, to that of liberating the unheard client voice.  Auditing can tell us an additional story regarding the quality of our services that we won’t hear directly from clients, that we won’t receive in consumer surveys and that we won’t know if we don’t go looking for it.  By presenting a change of the lens through which clinicians approach auditing, can this change our experience, our interpretation, our sense of value in the information gained and how we use this to improve services to clients?

The journey of revitalising clinical auditing through a change model that includes attention to this aspect of client centred focus (as giving voice to that which is otherwise unheard) will be shared to broaden this concept in deepening the authentic understanding of the service we provide as we continue our pursuit of excellence.

Biography

With a clinical background in Physiotherapy and post-graduate qualifications in business, Lisa has worked in both South Australia and the Northern Territory in a variety of clinical and leadership roles. This experience has led to a strong interest in how the complexity of contemporary health services can be best managed from the perspective of both clinicians and governing structures.

An online Allied Health Palliative Care resource

Deb Rawlings1, Jennifer Tieman2

1Palliative & Supportive Services, Flinders University, GPO Box 2100, Adelaide, 5001 South Australia deborah.rawlings@flinders.edu.au
2Palliative & Supportive Services, Flinders University, GPO Box 2100, Adelaide, 5001 South Australia Jennifer.tieman@flinders.edu.au

Background

CareSearch is an online evidence – based palliative care resource. It features an Allied health ‘Hub’ to recognise their vital role within multidisciplinary care. Hubs consolidate the knowledge base/practice issues for those involved in seeing people with palliative care needs. It provides easily accessible information for Allied Health Professionals that can help empower, motivate and educate in palliative care.

Methods

An advisory group supports ongoing development, providing feedback on the content, design and organisation of the hub as well as user testing. Pages are created within a knowledge translation framework and include summaries of the issues as well as practical resources that include DVDs, policy documents and weblinks. There are sections on clinical considerations, education, areas of practice, quality policy standards, interdisciplinary teams, and working with patients and consumers. There are also pages for consumers on the roles of allied health professionals.  Each page is peer reviewed.

In addition, there are PubMed topic searches specific to Allied Health, each featured discipline and to rural and remote issues.

Results

The Allied Health hub had 164,000 page views in the 2 years to November 2015.

Each member of the advisory group leads an edition of the bi-monthly newsletter focusing on their discipline. This includes a case story and a profile of someone working in palliative care. There are over 1,000 subscribers to this.

Discussion

CareSearch contributes to increasing the evidence base for palliative care for those working in Allied health with rigorous developmental processes to ensure currency and appropriateness of information.

Biography

Deb’s background is in Oncology and Palliative Care Nursing both in the UK and Australia. Deb is a lecturer in Palliative and Supportive Services, Flinders University and also works as a research fellow on CareSearch an evidence based website.

An intervention aimed at reducing the number of frequent attendances to hospital emergency departments

Jane George1, Lynne Briggs2

1West Coast District Health Board, Grey Hospital, PO Box 387, Greymouth, New Zealand jane.george@westcoastdhb.health.nz
2Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia l.briggs@griffith.edu.au

Background

A Health and Wellbeing Connection pilot study was undertaken by Richmond Services in partnership with Pegasus Health, Partnership Health, and the Canterbury District Health Board.

Objective

The aim of this study was evaluate an intervention program offered that assisted reduction of the number of frequent attenders to the Emergency Department at Christchurch Hospital.

Methods

The K10 Depression and Anxiety scale and the World Health Organization Quality of Life measure (WHOQOL) were administered to 105 people attending the Emergency Department repeated for the 53 participants who completed the intervention program.  Attendance rates at the Emergency Department and general practice were also recorded.

Results

The majority of the participants who completed the program had reduced their attendance at the Emergency Department significantly and all reported a decrease in psychological distress and an increase in their quality of life. There was no real change in their attendance rates at general practice centres.

Conclusion

While the number of participants in this study does not allow for robust analysis of efficacy it does indicate that there is merit in continuing to develop brief intervention case management models to support behaviour change programs for frequent attenders to Emergency Departments.

Biography

Jane George is Associate Director of Allied Health for the West Coast District Health Board.  She is a registered Social Worker, and has practiced in New Zealand and the United Kingdom.  Her research interests are centred on improving health outcomes for vulnerable populations in rural settings.  A primary goal is the use of strengths based leadership strategies to support staff to use innovation in response to change.  Jane is a Member of the Australasian College of Health Management, the Aotearoa New Zealand Association of Social Workers (MANZASW) and Health Informatics New Zealand (HINZ).

“Closing the gap through role-emerging occupational therapy positions”

Tahnee Elliot1, Kimberley Hunter2

1University of South Australia, Department of Rural Health, 111 Nicolson Avenue Whyalla Norrie, 5608, tahnee.elliot@unisa.edu.au
2University of South Australia, Department of Rural Health, 111 Nicolson Avenue Whyalla Norrie, 5608, kimberley.hunter@unisa.edu.au

Introduction

Kimberley and Tahnee are two Aboriginal new graduate occupational therapists from the University of South Australia, who are working as Aboriginal and Torres Strait Islander Allied Health Officers at the University Department of Rural Health in Whyalla.

Discussion

Occupational therapists work with individuals and groups throughout the lifespan promoting health and wellbeing through the engagement in meaningful occupations. Occupational therapy can offer a unique insight into community-centred practice as we are philosophically, theoretically and practically well situated to work collaboratively with communities. The key values underpinning community-centred approaches parallel client-centred practice, which is intrinsic to occupational therapy philosophy.

If occupational therapists were to work more broadly with communities, there would be greater potential for a larger population impact. Occupational therapists practicing in Australia are perfectly positioned to work together with Aboriginal communities to address the multitude of disadvantages faced by many.  By recognising Aboriginal People’s resilience and protective cultural factors occupational therapists can help to support meaningful engagement in life roles at both an individual and community level. Aboriginal holistic views of health and wellbeing, principles of primary health care and occupational therapy share a common comprehensive view of health. A combination of all three within community-centred practice offer an effective approach to addressing broader determinants of health.

Biography

Kimberley Hunter graduated from the University of South Australia with a Bachelor of Applied Science Occupational Therapy in 2015 and has since gained employment at the Department of Rural Health in Whyalla, South Australia as an Aboriginal and Torres Strait Islander Allied Health Officer. Kimberley is passionate about using her skills as an Occupational Therapist to help bring about change to social determinants impacting on the health of Aboriginal peoples.

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