Mrs Grace Edwards1,2, Mrs Megan Day1,2
1Sydney Local Health District, Camperdown, Australia, 2Flinders University, Bedford Park, Australia
Biography:
Grace Edwards is the End-of-Life Care Coordinator at SLHD, with extensive experience in acute care, clinical education, and service development. She leads initiatives to improve compassionate, culturally responsive care, advance care planning, and consumer engagement. Grace is currently involved in research on Kennedy Terminal Ulcers, Not-for-Resuscitation policy reviews, and evaluating the quality of end-of-life care in acute settings. She has presented on calciphylaxis, JMO ACP education initiatives and quality end of life care in the acute care setting. Grace is passionate about improving death literacy across consumers and clinicians, building workforce capability and embedding public health approaches into palliative care.
Abstract:
Background:
A district-wide End-of-Life (EOL) Audit conducted in 2023 across the Sydney Local Health District (SLHD) identified significant variability in symptom assessment and management during the Last Days of Life (LDOL). Clinicians reported low confidence in recognising and responding to symptoms, as well as challenges in supporting families and carers. In response, a LDOL Flip Chart was co-designed by specialist palliative care clinicians and subject matter experts in wound care, urogynaecology, and colorectal care. The Flip Chart was developed as a quick-reference tool to guide clinicians in symptom assessment, pharmacological and non-pharmacological management, and escalation strategies, with an emphasis on culturally safe care.
Aim:
To improve clinicians’ ability to assess and manage symptoms effectively during the LDOL, and to enhance the quality of care provided to patients and their families.
Methods:
This mixed-method qualitative study investigates the usability and feasibility of the LDOL Flip Chart across acute inpatient facilities within SLHD. Medical, nursing, and allied health clinicians were recruited over a six-month period using convenience sampling. Recruitment strategies included QR code-linked surveys and invitations to participate in focus groups. The intervention comprised targeted education sessions of nursing and allied health professionals. Primary outcomes included clinician-reported confidence in LDOL care, perceived improvements in care quality, and the practical utility of the Flip Chart in clinical settings.
Results:
The study is currently ongoing. Preliminary findings suggest that the Flip Chart is a useful and accessible resource, providing clear guidance on symptom control and supporting culturally responsive care for families and carers.
Conclusion:
Given that most Australians die in acute care settings, equipping clinicians—particularly nursing staff—with practical, scalable tools is essential. The LDOL Flip Chart represents a novel and context-specific resource to support high-quality EOL care, and to our knowledge, is the first of its kind tailored to acute inpatient environments