National Standards provide an important framework for all healthcare professionals in caring for people affected by life-limiting illness. The standards underpin safety and quality in healthcare, ensure consistency in service delivery and provide a nationally consistent statement about the level of care that people can expect from healthcare services.
The National Palliative Care Strategy provides a vision for palliative care in Australia and communicates the guiding principles and goals for palliative care service delivery.[1] Quality palliative care in Australia reflects the core values and principles of:[1]
| Dignity |
| Healthcare professionals should endeavour to maintain the dignity of the person, their caregiver/s and family. The dignity of the person should be prioritised at all times through a person-centred approach to overall care. This approach recognises that every person is unique and that their care needs will be different and can change over time. |
| Empowerment |
| Work with the strengths and limitations of the person and their caregiver/s and family to empower them to manage their own situation. |
| Compassion |
| Act with compassion towards the person and their caregiver/s and family. |
| Equity |
| Ensure that resources are accessible and are allocated equitably for all people affected by life-limiting illness. |
| Respect |
| Demonstrate respect for the person, their caregiver/s and family by providing a safe environment where all people affected by life-limiting illness can live and die with equity, respect and dignity – and without fear of prejudice and discrimination. |
| Advocacy |
| Advocate on behalf of the expressed wishes of the person, caregiver/s, families and communities. |
| Excellence |
| Healthcare professionals should be committed to the pursuit of excellence in the provision of care and support. |
| Accountability |
| As a healthcare professional you should be accountable to the person, caregiver/s, families and the community. |
The National Palliative Care Standards outline the standards and elements of quality care for all Australians. There are two key palliative care standards documents that apply in specialist and non-specialist settings. Standards underpin safety and quality in health care, ensure consistency in service delivery and provide a nationally consistent statement about the level of care consumers can expect from health services.[2]
| Standard 1: | Comprehensive assessment of needs: Initial and ongoing assessment comprehensively incorporates the person’s physical, psychological, cultural, social, and spiritual experiences and needs. |
| Standard 2 | Developing the comprehensive care plan: The person, their family and carers and substitute decision-maker/s work in partnership with multidisciplinary teams to communicate, plan, set goals of care and support informed decisions about the comprehensive care plan. |
| Standard 3 | Caring for carers: The needs and preferences of the person’s family and carers and substitute decision-maker/s are assessed, and directly inform provision of appropriate support and guidance about their role. |
| Standard 4 | Providing care: The provision of care is based on the assessed needs of the person, informed by evidence, and is consistent with the values, goals and preferences of the person as documented in their care plan. |
| Standard 5 | Transitions within and between services: Care is integrated across the person’s experience to ensure seamless transitions within and between services. |
| Standard 6 | Grief support: Families and carers have access to grief support services and are provided with information about loss and grief. |
| Standard 7 | Service culture: The service has a philosophy, strategy, values, culture, structure, and environment that supports the delivery of person and family-centred palliative care. |
| Standard 8 | Quality improvement: Services are engaged in quality improvement and research, based on best practice and evidence, to improve service provision and development. |
| Standard 9 | Staff qualifications and training: Staff and volunteers are appropriately qualified, are engaged in continuing professional development and are supported in their roles. |
| Care Standards (Standards 1 to 6) describe the systems and enablers necessary to deliver high-quality clinical care. Governance Standards (Standards 7 to 9) describe expectations in regards to quality management, quality improvement and benchmarking. | |
There are other national standards which relate to quality care provision for people with life-limiting illness, including:
- ACSQHC National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care[4]
- ACSQHC National Consensus Statement: Essential Elements for Safe and High-Quality Paediatric End-of-Life Care [5]
The National Consensus Statements were developed to support healthcare professionals who provide care in acute care settings where this care is not led by specialist palliative care providers team. However, these principles are also relevant in contexts other than acute care where care is not led by specialist providers.
Essential Elements
Care Processes: delivering comprehensive end-of-life care:
- Recognising end of life
- Patient-centred communication and shared decision-making
- Multidisciplinary collaboration and coordination of care
- Comprehensive care
- Responding to concerns
Organisational Processes: supporting comprehensive end-of-life care:
- Leadership and governance
- Support, education and training
- Care setting
- Evaluation, audit and feedback
- Systems to support high-quality care.[4]
Thinking Points
- Review the National Palliative Care Standards 1-6 reflect on the specific strategies that you would apply to meet these standards when caring for people affected by life-limiting illnesses.
- Maintaining dignity is a core value in palliative care. Within your scope of practice, what are some strategies that you would undertake to ensure a person’s dignity is maintained?
- The impact of asking, “What do I need to know about you as a person to give you the best care possible?” can be helpful in planning a person-centred approach to care. Reflect on when you may be able to include this in your daily practice.
References
- Australian Government Department of Health. 2019. The National Palliative Care Strategy 2018.
- Palliative Care Australia. 2024. National Palliative Care Standards. 2024 (Edition 5.1).
- Palliative Care Australia. 2022. National Palliative Care Standards for all Health Professionals and Aged Care Services
- Australian Commission on Safety and Quality in Health Care. 2023. National Consensus Statement: essential elements for safe and high-quality end-of-life care. Sydney.
- Australian Commission on Safety and Quality in Health Care. 2016. National Consensus Statement: essential elements for safe and high-quality paediatric end-of-life care. Sydney.