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Presentation Description
Institution: Western District Health Services - Victoria, Australia
Overview
In Victoria, approximately only 50 per cent of people connected to a designated community palliative care service (CPCS) who want to die at home do so. The 2016 Victorian end of life and palliative care framework supports people to receive end of life care and dying in their place of choice. However, in regional and remote areas, the inequality in access to afterhours supports, particularly for a necessary face-to-face contact, is a significant issue. Postcode lottery is a reality.
Integrating the role of the local government area Ambulance Victoria (AV) Paramedic Community Support Coordinator (PCSC) has been an important project to improve patient preferential outcomes
Aim
Development of a shared guidance module of care between AV and our CPPS was collaboratively developed to foster local connections, improve after hours support, and engage paramedics as part of a coordinated, local, timely and patient-centered level of care for people who live in rural and remote locations, shifting usual AV approach from ‘reactive emergencies’ responses to proactive healthcare.
Design/Method
Under a continuous improvement methodology, a communication system and referral pathway between the two service providers was established which included timely preemptive handovers; development of a 4 point communication system in home for: Advance Care Plans, Emergency Medical Booklet, Symptom management plan and Medication orders; point of care and post care discussions of call outs; and supportive education sessions to AV teams.
Results of findings/Data Collection
- Audits
- Compliance to preference to place of death demonstrated increased utilization of AV to achieve outcome:
- 1/1/2021-31/12/2021 55% (56 deaths-2 AV callouts) to 1/1/2022-31/12/2022 60% (54 deaths-7 AV call outs
- Change in practice evaluation demonstrated a shift in AV practices, particularly in negotiating situations that would have previously dictated paramedics would automatically be transporting a patient into hospital.
Conclusions/Lessons learned
- hour support had improved to access to every patient every time everywhere through partnerships and collaboration with AV.
- Success of the guidance module remaining independent of the AV PCSC contact person only.
- Ongoing education and training at the ground level for all AV staff within and beyond our LGA
Presenters
Authors
Authors
Mrs Erika Fisher - Western District Health Services
