Mrs Kelly Oakley1, Mrs Casey Martin1, Mrs Anne Bartle1
1East Metropolitan Health Service, Perth, Australia
Biography:
Kelly Oakley is a Clinical Nurse Specialist and Project Lead at East Metropolitan Health Service, driving palliative care improvement initiatives, including the Supportive Palliative Indicator Tool and Symptoms Assessment Tool rollout across acute and aged care settings.
Casey Martin is a Clinical Nurse Specialist in Palliative Care, providing expert clinical guidance and supporting multidisciplinary teams to enhance palliative care and patient outcomes.
Anne Bartle is a Clinical Nurse with extensive experience in acute and geriatric care, contributing to the integration of palliative principles and supporting quality improvement across clinical areas.
Abstract:
Background:
The National Partnership Agreement on Comprehensive Palliative Care in Aged Care (NPA CPCiAC), introduced in 2018–2024, aimed to address inconsistent palliative care across residential aged care facilities (RACFs). It provided Commonwealth funding to expand care models, strengthen decision-making, and build workforce capacity for older Australians.
Since 2023, East Metropolitan Health Service has run a pilot project to integrate two key tools to improve palliative care outcomes for RACF patients: the Supportive and Palliative Care Indicators Tool (SPICT) and the Symptom Assessment Scale (SAS).
Aims:
The rollout of SPICT and SAS aims support timely identification of patients with life-limiting illness, enabling proactive care planning and earlier referral to specialist palliative care. It also aims to enhance communication and shared decision-making with patients, families, and RACFs. SAS enables consistent symptom monitoring, rapid escalation of care, and measurable data to track outcomes and improve quality.
Methods:
A multilayered implementation strategy embedded SPICT for early identification and SAS for routine symptom monitoring. Project aims and workflow changes were communicated through multidisciplinary and service meetings. Targeted training, bedside coaching, and educational tools—including a SPICT guidance video developed as part of the project—supported staff competency. Tools were integrated into clinical documentation platforms and dashboards to ensure transparency.
Results:
Implementation fostered positive cultural change and staff empowerment in addressing palliative care needs. SPICT use improved documentation of Goals of Patient Care (GOPC), aligning care with patient wishes. Earlier identification of deteriorating patients enabled timely planning and reduced reactive responses. Enhanced referrals to specialist palliative care potentially reduced hospital transfers and patient distress.
Conclusion:
This initiative has shifted care from reactive to proactive, improving care planning and outcomes for deteriorating older patients and strengthening coordination between hospitals and RACFs.