Dr Claudia Virdun1,2, Professor Alison Mudge5,7, Dr Gursharan Singh2, Associate Professor Hannah Carter4, Dr Elise Button2,6, Distinguished Professor Patsy Yates2, Professor Jane Phillips2, Ms Lee Jones3,4
1Research Centre for Palliative Care, Death, and Dying, College of Nursing and Health Sciences, Flinders University, Brisbane, Australia, 2Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology (QUT), Brisbane, Australia, 3QIMR Berghofer Medical Research Institute, Brisbane, Australia, 4Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia, 5Internal Medicine and Aged Care, Department of Internal Medicine and Aged Care, Royal Brisbane and Women’s Hospital, Brisbane, Australia, 6Caring Futures Institute, Flinders University, Adelaide, Australia, 7Centre for Health Services Research, The University of Queensland, Brisbane, Australia
Biography:
Dr Claudia Virdun is a specialist palliative care nurse, researcher, and educator committed to improving care for people with advanced illness. She is a Senior Lecturer in Palliative and End of Life Care at Flinders University. Claudia’s work spans clinical practice, research, and policy, with a strong focus on consumer co-design, quality improvement, and workforce development. Her research has informed national and international guidelines, and she has received multiple awards for excellence in teaching and research. Claudia is passionate about embedding lived experience into healthcare systems and advancing evidence-based palliative care across diverse settings.
Abstract:
Background:
One third of hospitalised patients are living with advanced serious illness, and one fifth will die within the next 12 months. Optimal palliative care cannot be assured for these patients.
Aim:
To evaluate the effect of a complex intervention that included collection and feedback of patient experience data and facilitation to empower ward-based quality improvements for inpatients with advanced serious illness.
Methods:
A pre-post quality improvement study using a repeated patient reported experience measure over time to understand the effect of a complex intervention. The intervention was the implementation of an improvement bundle titled Listen, Empower and Act to improve Palliative care (‘LEAP bundle’). The LEAP bundle consists of: ‘Listening’ – collecting patient reported experience (PREM) data, and context assessments via the multidisciplinary team; ‘Empowering’ – co-design of improvement foci informed by PREM data and facilitated working groups to guide innovation development; ‘Acting’ – innovation implementation. Measure of effect occurred using consideRATE, a validated PREM designed for inpatients with serious illness.
Results:
The three participating wards successfully completed the intervention across all time periods, with modifications made to account for local contextual requirements. Clinicians (n=88) described key challenges and opportunities for providing optimal inpatient palliative care. 67 working groups occurred supporting clinical teams to design and implement innovations – from ideas to impact. Improvement in patient reported experience was achieved across all consideRATE questions addressing: symptom management, psychological care, care aligned to what matters most to the patient, optimal communication and adequate environment.
Conclusion:
Implementation of the LEAP bundle led to improved palliative care within three wards in one large hospital. Testing the impact of implementing LEAP across more clinical sites is an important next step.