Historically, palliative care in-reach consultation was provided on request to this tertiary referral hospital by a local satellite palliative care service. This in-reach service aimed to review patients within 72 hours of referral. To meet increased patient need an on-site nurse-led palliative care service was proposed.
To improve patient and carer outcomes through the provision of an on-site nurse-led specialist palliative care service.
Two palliative care clinicians; a Transitional Nurse Practitioner and a Clinical Nurse Consultant, were recruited to establish a service. After consulting with key stakeholders, a model of care was proposed that aligned with and was informed by the National Safety and Quality Health Service Standards and National Palliative Care standards.
A model of care was developed and implemented throughout the campus. Since service inception in late 2018 referrals have grown rapidly; from zero to 1685. Furthermore, referrals to the service are now routinely received from more than 20 admitting medical and surgical specialties.
Demonstrating the value of specialist palliative care integration to complement and improve patient outcomes has facilitated a paradigm shift amongst clinicians with attitudinal and cultural change resulting. Diagnosis data indicates that patients referred to the nurse-led service are almost evenly split; 55% malignancy and 45% non-malignant. These figures demonstrate the recognition of the role of palliative care for life-limiting illness, regardless of diagnosis.
The success of this nurse-led service underscores the benefits of early integration of palliative care within the acute presentation. Additionally, continuity of care is ensured with patients linked with their domiciled community palliative care team on discharge from the hospital. Service growth has ensued and the team has expanded to include a Social Worker and an Aboriginal Health Worker. Requests are now being received for the team to play a role in the chronic disease outpatient clinics conducted at the hospital.
Sustainability of this innovative nurse-led service is demonstrated by integration of research, staff education, evaluation and implementation of service benchmarking. This nurse-led service, whilst in its infancy, has already demonstrated its crucial role in improving patient and family care outcomes.
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