Putting palliative patients first a winning model

Australian Private Hospitals Association

A model of palliative care that has improved patient choice in end of life care and place of death has been recognised in the Australian Private Hospitals Association (APHA) Awards for Excellence.

The Sydney Adventist Hospital, San Community Palliative Care Service (the service) has won the Clinical Excellence – quality of care and patient outcomes category of the national awards.

Developed to complement existing inpatient palliative care, the service provides access to specialist services that can deal with complex care in a community setting. It is available to adult palliative care patients living within 10-15 km of the hospital.

APHA CEO Michael Roff said the awards were an opportunity to showcase the great work private hospitals do in meeting the needs of their communities.

“This is a wonderful example of a private hospital seeking feedback from patients about their wishes at end of life and implementing a program that has seen almost all of those patients in the 2018-2019 period die in their preferred place.

“We know Australians want to die at home – according to a 2017 Productivity Commission report – 70 percent of us would prefer to die at home, while only around 10 percent of patients do so. This program is also an example of private hospitals providing specialist care outside the hospitals walls, something they would do more of if it was properly funded through private health insurance.

“This model is only able to be delivered through philanthropy,” he said.

The service has implemented a number of strategies to improve patient outcomes when it comes to end of life wishes. One example is the introduction of ‘Patient Medical Alert Cards’ notifying emergency department staff the patient is known to the palliative care service.

With this information, ED staff can access resuscitation and advance care directives, helping to prevent unwanted and futile investigations and procedures. Facility fees for re-entry to the hospital are waived for these patients.

There has been a significant improvement in patients’ end of life wishes being met. Research on the model shows patients were much more likely to die at home, there were fewer hospital admissions overall, with significant cost savings demonstrated.

Award judges were very impressed with the program and results, one suggesting ‘this initiative could become a national demonstration site’.

APHA Awards for Excellence judging panel:

Tony Lawson, Chair, Consumer Health Forum

Adjunct Professor Debora Picone AO, CEO, Australian Commission on Safety and Quality in Health Care

Michael Roff, CEO, Australian Private Hospitals Association

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