Optimising care for People with palliative care needs, and their families, in the Australian hospital setting: the OPAL Project
- Publication Type:
- Thesis
- Issue Date:
- 2021
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𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱
Demand for palliative care provision within hospitals is significant and projected to increase in line with the population ageing and an increase in non-communicable disease. However, not all Australian inpatients with palliative care needs have access to best evidence-based quality care. Understanding how to optimise care for this population is a global priority.
𝗔𝗶𝗺
To identify how to optimise care for people with palliative care needs and their families in the Australian hospital setting.
𝗠𝗲𝘁𝗵𝗼𝗱𝘀
A three phase fully mixed sequential dominant design. The OPAL Project is informed by pragmatic assumptions and the Innovative Care for Chronic Conditions and Person-centred Practice Frameworks. Phase 1 focused on scoping the problem and involved a systematic review and meta-synthesis of the needs of inpatients with palliative care needs and their families (Studies 1a and b). Phase 2 involved a qualitative interview study with patients and families to better understand domains of importance, their implications for practice and relevance for the Australian population (Study 2). A mid-point meta-inference of data obtained across Studies 1a, 1b and 2 followed, to inform Phase 3 and project conclusions. Phase 3 included a global environmental scan (Study 3) and a co-design workshop (Study 4) focused on understanding how to drive reform in relation to Australian inpatient palliative care. The end-point meta-inference drew together all of the OPAL Project’s data to generate a series of recommendations.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀
The OPAL Project identified that Person-centered care, Expert care and Optimal environment of care are the three overarching categories of importance to inpatients with palliative care needs and their families. Within each of these three categories are specific care-related domains (n=14) and a series of practice points (n=68), that provide guidance at the macro, meso and micro levels. The end-point meta-inference identified five key drivers for embedding the categories and domains identified in the OPAL Project, including: recognising and valuing palliative care as core business and a priority for inpatient care; leadership; measurement; innovation; and targeted skill development to support clinicians and ancillary staff in their delivery of palliative care.
𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻
Improving inpatient palliative care requires a concerted effort to enable the implementation of strategies aligned with the care that matters most to inpatients with palliative care needs and their families. The OPAL Project provides a robust platform for clinicians, health administrators and policy experts to re-orient their inpatient palliative care policy focus, improvement indicators and skill development on what matters most to inpatients and families with palliative care needs. System-level improvement will only occur with discrete but interrelated work undertaken in partnership with all stakeholders, including palliative care consumers, at the macro (national), meso (hospital) and micro (ward) levels.
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