Equitable access to palliative care thanks to telehealth

Friday, October 28, 2022

As we see out Telehealth Awareness Week for 2022, today we showcase the excellent work of Central Queensland’s Specialist Palliative Care in Aged Care (CQ SPACE) and their use of telehealth to further their reach.

SPACE is designed to build the capacity and capability of aged care nurses to deliver palliative care as core business. Specialist palliative care services are not available within all rural and remote areas, therefore keeping residents in their familiar environment is imperative. Upskilling local staff is vital to ensure Queenslanders receive high quality end of life care, in line with their wishes.

With 21 residential aged care facilities and seven multi-purpose health services with aged care beds in the Central Queensland Hospital and Health Service’s catchment area, the team needed an innovative approach in order to ensure all aged care staff were supported. Jennifer Bearham, Clinical Nurse Consultant, Project Lead SPACE for CQHHS is working closely with the Central Queensland, Wide Bay, and Sunshine Coast Primary Health Network (PHN) and their Specialist Palliative Care Rural Telehealth (SPaRTa) program to deliver in-house and virtual palliative care education and support.

This includes a unique ‘Needs Round’ which sees Jennifer sit down – virtually or in person – with the nursing team. “A Needs Round is a proactive consultancy model where we partner with residential aged care staff and help them identify patients at risk of deterioration. It’s a case-based discussion, not just about symptoms and management of symptoms, but the opportunity to talk about any concerns about a resident and how they could be managed,” Jennifer said.

“Needs Rounds create a safe space for staff to ask questions about palliative care, both in general, and resident-specific. Needs Rounds are new, so there are challenges; aged care providers are often surprised at first and will ask ‘you’re coming before anyone is sick!?’ And yes, we do. I explain to them that it’s a quality activity, providing case-based education for staff where the residents benefit too because they get a clinical review by a palliative care doctor,” Jennifer said.

Jennifer also speaks with residents and families as part of the Needs Round to make sure the advance care planning documents are up to date and uploaded to The Viewer. The team also make recommendations to GPs about medications and keep them informed about their patient. “My focus is on advance care planning and nursing pre-assessment. I will meet with families wherever they feel comfortable. We get support from GPs before we see their patient which makes it easier for the nursing staff as well,” she said.

And thanks to the power of telehealth and the support from SPaRTa and PallConsult, Jennifer is now able to take the Needs Rounds to more rural and remote facilities. “Asking nurses to hold an iPad for an hour or more so we could see a patient wasn’t practical and taking a laptop from resident to resident wasn’t good for infection control. So, we now have Nova Pro Mobile Tablet Station which addresses the infection control concerns,” Jennifer said.

And she said while it was early days using the new approach, they’ve received good feedback. “We’ve now successfully done two telehealth Needs Rounds in rural Central Queensland. The staff had good feedback but there’s always scope for improvement.”

“There are challenges, but it’s worth pushing through. We are bridging the gap in healthcare by assisting residential aged care providers to access specialist palliative care services in rural and regional facilities, and that is a great privilege.”

Last updated: 28 October 2022