Ms Gloria Pavey1, Ms Le-Tisha Kable
1Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Australia
Biography:
Gloria is a Nurse Consultant at Royal Prince Alfred Hospital Sydney since 2020 Gloria has a background in community palliative care and has completed a Master of Palliative Care at Flinders University.
Abstract:
Background:
Royal Prince Alfred Hospital (RPA) is a leading quaternary referral centre in New South Wales.
RPA Palliative Care Consultation Service implemented the Palliative Care Outcomes Collaboration (PCOC) program in July 2024.
In the first 12-month period of PCOC data collection there were. 528 patients assessed by the service with 570 episodes of care.
Analysis of the July–December 2024 reporting period show the PCOC benchmark—90% of patients in the unstable phase for ≤3 days—was not met, with 37% (n=54) of patients remaining unstable for ≥4 days. The initial benchmark reached was 63%.
Aim:
90% of Palliative Care Consult patients are in the unstable phase for 3 days or less, reducing those remaining unstable for ≥4 days.
Methods:
A sequential Plan–Do–Study–Act (PDSA) framework was applied, aligned with 6-month PCOC reporting periods.
–Cycle 1 (Jul–Dec 2024):
–Conducted a site self-assessment against PCOC’s five key strategies and 25 enabling factors
–Case Review Audit of 20 patients with prolonged unstable phases revealed gaps in understanding of phase definitions.
–Revised education program with a data entry cheat sheet and RPA specific PCOC Education Matrix, to enhance staff education and phase recognition.
–Cycle 2 (Jan–Jun 2025):
–Despite targeted interventions, no significant improvement was observed.
–Interventions included nurse-led leadership, redesign of assessment workflow and handover processes, educational survey and feedback collection, revised orientation program, senior clinician education sessions, and ongoing phase audit-feedback processes.
Results:
Preliminary data from the July–December 2025 reporting period indicate a reduction in patients remaining in the unstable phase ≥4 days, showing progress toward the national benchmark.
Conclusion:
Nurse-led leadership, structured education, Assessment workflow and handover process redesign, and audit-feedback mechanisms have improved phase recognition and timeliness of symptom stabilization. Ongoing PDSA cycles will aim to sustain improvements to achieve and maintain national benchmarks.