Palliative Care Capabilities
All healthcare providers require development of fundamental capabilities to provide palliative care, appropriate to their discipline and scope of practice. This generalist workforce is essential in the provision of safe and high-quality palliative care. Some members of the health workforce develop increased level and depth of palliative care capability and practice as palliative care specialists. A broad, whole-of-workforce approach to build health professionals’ capacity to meet palliative care needs is required and is reflected in the Palliative Care Workforce Development Model.
Figure 1: Palliative Care Workforce Development Model (Click to enlarge)
Australian regulatory bodies have developed accreditation and credentialing requirements or have defined National Standards that provide frameworks underpinning healthcare provider practice. The palliative care workforce capabilities are intended to complement existing professional and workforce standards that are specific to each of the various health disciplines. The application of palliative care capabilities will depend on the scope and context of practice for a particular healthcare provider.
Who?
All healthcare professionals who provide care to people living with life-limiting illness, their families, and carers. This includes registered and enrolled nurses, medical practitioners, Aboriginal and Torres Strait Islander health practitioners and allied health professionals.
How?
Capability achieved within entry-to-practice education (AQF Levels 4-9) and updated through postgraduate learning, professional experience, and ongoing professional development.
What?
Four graduate capabilities in palliative care were identified as being integral for all health professionals through consultative activities undertaken in an early phase of the PCC4U project. The ‘graduate capabilities in palliative care’ were informed by literature, scoping of curricula, survey of healthcare professionals and focus group discussions. A summary of key findings can be found in Principles for including palliative care in undergraduate curricula.1
HP1: Person-centred communication in the context of an individual’s responses to loss and grief, existential challenges, uncertainty and changing goals of care.
HP2: Appreciation of and demonstrated respect for the diverse human and clinical responses of each individual throughout their illness trajectory.
HP3: Understanding of principles for assessment and management of clinical and supportive care needs.
HP4: The capacity for reflection and self-evaluation of one’s professional and personal experiences and their cumulative impact on oneself and others.
1Palliative Care Curriculum for Undergraduates (PCC4U) Project Team. (2012). Principles for including palliative care in undergraduate curricula. Brisbane, QLD: QUT.
Who?
All healthcare workers who provide care to people living with life-limiting illness, their families, and carers. This includes personal care assistants, allied health assistants, care workers and Aboriginal and Torres Strait Islander health workers
How?
Capability achieved within entry-to-practice education (AQF Levels 3-4) and updated through work experience and ongoing professional development.
What?
Palliative care capabilities for care workers were adapted from the PCC4U ‘graduate capabilities in palliative care’. They have been endorsed through stakeholder consultation.
CW1: Person-centred communication to build trust, show empathy and demonstrate support for individuals and carers living with a life-limiting illness.
CW2: Awareness of and demonstrated respect for the diverse human and clinical responses of each individual throughout their illness trajectory.
CW3: Understanding of clinical and supportive strategies that are within the scope of practice for individuals with a life-limiting illness.
CW4: The capacity to identify own emotional responses and ethical concerns and manage according to organisational policy and procedures.
Who?
Healthcare professionals whose core activity is provision of care to people living with life-limiting illness, their families, and carers and provision of professional support for the generalist workforce.
How?
Higher-level knowledge and more advanced application of palliative care skills is required reflecting the specialist capabilities in palliative care. Capability developed through formal qualifications achieved through postgraduate learning in courses ranging from AQF Level 8 to 10. Capability is continually updated through ongoing professional development. Discipline-specific specialist palliative care capabilities may also underpin practice, education, and training.
What?
Specialist palliative care capabilities build upon the graduate capabilities in palliative care. Palliative care capabilities for specialist palliative care professionals were informed by:
• Palliative Care Service Development Guidelines2
• Discipline-specific specialist palliative care competencies and standards defined by professional bodies
• International palliative care service development frameworks
• Stakeholder review and forums.
S1: Advanced communication skills to establish, maintain and adapt effective therapeutic partnerships in the context of an individual’s responses to loss and grief, existential challenges, uncertainty and changing goals of care.
S2: The ability to negotiate mutually agreed goals of care within a therapeutic environment, and facilitate person-centred decision making to promote optimal outcomes.
S3: Demonstrated skills in providing individualised and evidence-based interventions to address the diverse human and clinical responses and preferences of each individual throughout their illness trajectory.
S4: Advanced skills in holistic assessment of individuals with complex clinical and supportive care needs.
S5: Expertise in use of assessment data to develop and implement a personalised and evidence-based management plan and modify this plan according to changing circumstances, needs and preferences.
S6: Understand the need for support for self and others and utilise appropriate support systems.
S7: Contribute to quality palliative care outcomes through research, professional, policy and service development activities.
S8: The ability to apply advanced understanding of contemporary legal, ethical and professional standards in palliative care service delivery and development.
2 Palliative Care Australia. (2018). Palliative Care Service Development Guidelines. Palliative Care Australia.
Capability statements for academics, educators and health professionals are intended to support their work developing students and clinicians develop palliative care capabilities at the generalist and specialist levels.
E1: Develop discipline-specific intended learning outcomes based on palliative care capabilities.
E2: Use reputable learning and teaching resources to support learner’s development of palliative care capabilities.
E3: Apply evidence-based learning and teaching strategies in palliative care education.