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.
Quality palliative care in Australia reflects the core values and principles of:[2, 3]
|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.|
|Work with the strengths and limitations of the person and their caregiver/s and family to empower them to manage their own situation.|
|Act with compassion towards the person and their caregiver/s and family.|
|Ensure that resources are accessible and are allocated equitably for all people affected by life-limiting illness.|
|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.|
|Advocate on behalf of the expressed wishes of the person, caregiver/s, families and communities.|
|Healthcare professionals should be committed to the pursuit of excellence in the provision of care and support.|
|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 by specialist palliative care services. Although they are specifically designed for specialist palliative care providers, they provide an important framework for all healthcare professionals involved in caring for people affected by life-limiting illness. 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.[4, 5]
|Standard 1||Initial and ongoing assessment incorporates the person’s physical, psychological, cultural, social and spiritual experiences and needs.|
|Standard 2||The person, their family and carers work in partnership with the team to communicate, plan, set goals of care and support informed decisions about the care plan.|
|Standard 3||The person’s family and carers needs are assessed and directly inform provision of appropriate support and guidance about their role.|
|Standard 4||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||Care is integrated across the person’s experience to ensure seamless transitions within and between services.|
|Standard 6||Families and carers have access to bereavement support services and are provided with information about loss and grief.|
|Standard 7||The service has a philosophy, values, culture, structure and environment that supports the delivery of person-centred palliative care and end-of-life care.|
|Standard 8||Services are engaged in quality improvement and research to improve service provision and development.|
|Standard 9||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.
The Palliative Care Service Development Guidelines further communicate the expectations for service provision and workforce and system capabilities to support the delivery of quality care.
There are other national standards which relate to quality care provision for people with life-limiting illnesses, including:
- ACSQHC National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care.
- ACSQHC National Consensus Statement: Essential Elements for Safe and High-Quality Paediatric End-of-Life Care
- Aged Care Quality Standards
The National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care was developed to support healthcare professionals who provide care in acute care settings where this care is not being led by a specialist palliative care doctor or team. The essential elements within the Consensus Statement are the features that are required in systems to ensure safe and high-quality care for patients who are approaching the end of life.
Processes of care:
- Patient-centred communication and shared decision-making
- Teamwork and coordination of care
- Components of care
- Use of triggers to recognise patients approaching the end of life
- Response to concerns
- Leadership and governance
- Education and training
- Supervision and support for interdisciplinary team members
- Evaluation, audit and feedback
- Systems to support high-quality care.
- Review the National Palliative Care Standards 1-6 (pages 13–18). 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.
- Australian Government Department of Health. The National Palliative Care Strategy 2018. 2019 [cited 2019 June 26].
- Palliative Care Australia. What is Palliative Care? 2015 [cited 2019 January 23]; Available from: https://palliativecare.org.au/what-is-palliative-care.
- Palliative Care Australia. National Palliative Care Standards. 2018; 5th Edition:[Available from: http://palliativecare.org.au/standards].
- Australian Commission on Safety and Quality in Health Care, National Safety and Quality Health Service Standards. 2012: ACSQHC.
- Australian Commission on Safety and Quality in Health care, National Consensus Statement: essential elements for safe and high-quality end-of-life care. 2015, ACSQHC: Sydney.
- Palliative Care Australia. Palliative Care Service Development Guidelines. 2018; Available from: http://palliativecare.org.au/quality.