Planning for Palliative Care Provision / Acute Care / Settings of Care / Health Professionals

Organisations need to be prepared and clinicians supported

Organisational readiness is often thought of in terms of policies and guidance to manage care of the dying. [1] In the end-of-life care or terminal care context this includes how to communicate with and provide privacy for patients and families, and how to deliver culturally responsive care. Failure to be prepared can lead to patient safety concerns including: [1]

Poor communication
Not considering a palliative approach to care
Applying a one size fits all approach
Families feeling uninformed of how to best support the patient
Poor nursing care
Lack of timely attention
Fragmented care.

Visit End-of-Life Essentials accreditation and management modules.

Accreditation and management modules

There are several models, pathways, and frameworks currently used within the acute care setting to guide the delivery of palliative care. These might be adapted for local use. Most guide in-hospital care including transitions between hospital units, and some include transition to external settings such as home or aged care.

As context matters when planning and providing care the following examples are listed according to intended patient group or situation. Access to specialist palliative care is often included but is not always available. State and Territory palliative care advice lines providing external specialist input are also listed below and where needed might be incorporated into plans.

For adult care

Clinical Services Capability Framework for Palliative Care integrates care across in-hospital and out of hospital settings and links with primary providers.
Nurse-led Palliative Care Service in Australia: An Implementation toolkit (698kb pdf) optimises nurses’ contribution to palliative and end-of-life care.
NSW Renal Supportive Care Service Model (370kb pdf) is a multidisciplinary approach to integrating renal medicine and palliative care.
Dementia Care in Hospitals Program educates clinicians on dementia, delirium, and cognitive impairment.
PCOC Assessment and Response Protocol supports clinicians to identify, respond to and communicate patient, family and carer’s needs.
AMBER care bundle encourages clinicians, patients and families to continue with treatment in the hope of recovery, whilst communicating about preferences and plans for preparing for end of life.
DandELinE is a standardised early assessment pathway and shared decision-making model for quality end-of-life care within hospital emergency departments.

For paediatric care

Victorian Paediatric Palliative Care Program is a consultation-liaison team based approach to the facilitation of care of children with palliative care needs and their families.
Western Australian Paediatric Palliative Care Service provides support to children, parents and carers, as well as clinical staff and community-based services.
New South Wales state wide paediatric palliative care service consists of hospital teams that connect with local hospital, paediatric and community health teams to support patients and families to be cared for at home or in their local hospital.

COVID-19 models of care

COVID Geriatric Healthcare Organisation Model is a telephone-based model to assist with geriatric assessment and the coordination of care across the acute and primary care settings.
Framework for proactively mobilizing the palliative care workforce addresses goals of care through communication and symptom management.

Local specialist palliative care advice services

Where patient needs are complex or specialist support for local services is needed, most states and territories of Australia also operate advice lines.