Mr Nathan McGrath1, Dr Claudia Virdun2,3,4, Ms Alison Boccari1, Ms Tina Byford1, Ms Emma O'Brien1, Dr Geoff Fanning1, Mr Jared Grayling1, Ms Jenn Walker1, Dr Alison Kearney1
1Royal Brisbane and Women’s Hospital, Metro North Health and Hospital Service, Brisbane, Australia, 2College of Nursing and Health Sciences, Flinders University, Adelaide, Australia, 3Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, Australia, 4Faculty of Health, University of Technology Sydney, Sydney, Australia
Biography:
Nathan McGrath is an experienced nurse currently specialising in general medicine and respiratory care. His experience in nursing extends through General Medicine, Respiratory, Haematology and Bone Marrow Transplantation, Neurosurgery and Intensive Care Nursing. Nathan has a passion for excellence in nursing care and is committed to providing the best care possible for each individual patient, from their acute care needs through to palliative and end of life care. Nathan has completed postgraduate study in the field of critical care and is currently the Nurse Unit Manager of a general medicine and respiratory unit at the Royal Brisbane and Women’s Hospital.
Abstract:
Background: The need to improve hospital palliative care is well noted particularly when considering general medical and respiratory patients.
Aim: To support improvement in integrated palliative care in a general medical and respiratory ward informed by patient reported experience measure (PREM) data.
Methods: A mixed methods study: Phase 1 – baseline PREM collection (patient perspectives) and clinician interviews; and co-design of prioritised area for improvement; Phase 2 – weekly working-group meetings to design and test innovations; and ongoing PREM collection and feedback. Participants were recruited from the general medical and respiratory ward of an Australian tertiary metropolitan hospital.
Results: Phase 1 (Sept-Nov 22) – PREM data collected from 31 patients and 9 carers, and 29 clinician interviews completed. Co-design meetings highlighted area of focus being: communication with patients and families about the future, what to expect and likely prognosis. Phase 2 (Apr-Nov 23) – multi-disciplinary working-group formed and met 25 times. Two innovations designed and tested: 1. Implementation of a form that screens for palliative care needs using the CriSTAL (Criteria for Screening and Triaging to Appropriate End of Life Care) tool supported by 5 key care planning questions. Audit completed on 2 occasions to inform rapid cycle improvement work; 2. A leaflet to inform patients and carers of key questions they may want to consider designed and implemented; 184 PREM surveys collected (165 patients and 19 carers) and feedback monthly. Improved care experience was noted from baseline to study completion. All PREM data and study results will be presented, including newly designed tools and implementation processes.
Conclusions: Driving change based on PREM data enables clinical teams to remain focused on what matters most for patients and families. Nursing leadership is ideally positioned to drive improved ward-based palliative care, with support from medical colleagues and executive leadership.