Ms Allison Lovell1, Dr Elise Button1, Ms Natalie Kruger1
1Care at the End of Life, Clinical Excellence Queensland, Queensland Department of Health,
Biography:
Allison is a palliative care health services leader and experienced clinician. She has implemented statewide palliative care initiatives on behalf of Queensland Health since 2016. Allison has practiced in senior nursing roles locally and internationally. She has been the Vice President and Treasurer of Palliative Care Nurses Australia. Allison completed a Master of Health Management in 2014 and was appointed a Fellow of the Australasian College of Health Service Management in 2018. In 2019 Allison spent a year in China as a Program Consultant on Hospital Management where she provided recommendations on person-centred healthcare at the Zhongshan Ophthalmic Centre.
Abstract:
Background: Many people require resource intensive care near the end of life (EOL). This care is often low-value, leading to limited or no benefit, or causing harm to patients and families. In response to a ministerial priority area around enabling high-value care, a project team within Clinical Excellence Queensland was tasked with addressing this issue.
Aim: The project aimed to identify an appropriate solution to empower multidisciplinary clinicians across Queensland to deliver high-value care for people with life-limiting illnesses.
Methods: A series of clinician-led workshops established, defined, and explored a problem around low-value care near the EOL, and developed a ‘solution’. Concurrently, a series of Kitchen Table discussions were conducted with consumers exploring the concept of high- and low-value care, and how they could be empowered to participate in decisions about treatment and care. Extensive design, and clinician and consumer user testing of the ‘solution’ were led by a User Experience Designer.
Results: A generic patient decision aid (PDA), named the Care Companion, was developed as the ‘solution’ in response to the defined problem: “People with a life limiting illness, and those involved in their care, often don’t receive the information and support they need to fully participate in shared decision-making about treatment and care that is right for them.” The PDA (named Care Companion) supported shared decision-making between patients and clinicians by providing information about the available treatment options, the associated risks and benefits, uncertainties associated with each option, and a patient value clarification exercise. It was developed in an electronic and paper format for use across Queensland.
Conclusion: The PDA was developed in response to identified need for greater shared decision-making for people with life-limiting illness. Current work is underway to exploring implementation of the PDA in the clinical setting to enable high-value care at the EOL