The Palliative Aged Care Outcomes Program won the Palliative Care category in the 2023 Future of Ageing Awards.
The Palliative Aged Care Outcomes Program (PACOP) is a comprehensive initiative dedicated to enhancing the care and outcomes of individuals residing in residential aged care, with a particular emphasis on those approaching the end of life. Developed in response to The Royal Commission into Aged Care Quality & Safety, PACOP seeks to address the urgent need to improve the quality of care for residents in aged care homes (ACHs) facing the end of life.
Why it came about
With nearly 60,000 people in ACHs passing away annually and a growing trend of residents becoming increasingly frail upon admission, the Royal Commission identified end-of-life care as a crucial aspect of ACHs’ responsibilities. PACOP was initiated by the University of Wollongong, building upon the success of the Palliative Care Outcomes Collaboration (PCOC) in specialist palliative care settings.
A philanthropic grant in 2019 from the J.O and J.R Wicking Trust facilitated the pilot phase, navigating challenges posed by the Royal Commission, bushfires, floods, and the COVID-19 pandemic.
Objective
PACOP aims to provide a nationally consistent framework, facilitating improvements in palliative and end-of-life care at resident, provider, and system levels. By embedding standardised tools and outcome assessments, PACOP assists ACHs in identifying, understanding, and addressing the palliative care needs of residents, promoting appropriate and timely care planning. The Australian Government Department of Health and Aged Care funds the program.
Implementation
PACOP operates through two main collections: the Profile Collection, involving routine assessments every three months to identify deteriorating residents, and the Outcomes Collection, initiated when palliative care is deemed necessary. These collections employ standardised assessments for symptom severity, functional status, and frailty. The program employs an ‘all of staff’ approach to monitoring residents’ concerns and provides improvement facilitators for education and support.
Benefits
The implementation of PACOP addresses several gaps in the aged care sector. It introduces a standardised approach to palliative and end-of-life care, empowers staff, fosters communication, and facilitates genuine comparison between aged care homes through the first-ever national benchmarking program. The program aims to improve residents’ quality of life, empower families, and demonstrate compliance with National Aged Care Standards.
Evidence of Success
Since its commencement in 2021, PACOP has exceeded recruitment targets, potentially reaching over 51,000 residents in 698 aged care homes. Positive feedback from ACHs indicates improved end-of-life care practices and the identification of palliative care needs.
Summary of a provided testimonial: One of Australia’s major aged care organisations has chosen PACOP as their preferred palliative care model, registering 27 Aged Care Homes (ACHs) with approximately 2700 residents within eight months of training initiation.
Implementing PACOP, they conducted Profile assessments in January 2023, revealing 33 residents in need of palliative care. This led to the commencement of the PACOP Outcomes Collection. The organisation’s proactive use of PACOP facilitated the early identification of residents’ palliative needs, resulting in improved end-of-life care. Feedback from senior staff highlighted a correlation between PACOP assessments and Quality Indicator findings, demonstrating its impact on care quality.
The program conducts regular education sessions, collaborates with stakeholders, and has received collaborative agreements with primary health networks and local health services throughout Australia.
“Allowed me to easily see the stages of care a resident needs and support a family might require. Gave me the confidence to talk with specialist and families having tools to back me up. Saw that the care staff were able to provide the best type of care which gave me greater confidence in my team”
RN Eva Tilley – Workshop participant
Who was involved
The PACOP team:
- National Director – Professor Claire Johnson
- National Quality & Education Manager – Janelle White
- Senior Administration Officer – Zoe Knight
- Data manager/Statistician – Alanna Connolly
- Statistician – Stephen Moules
- Data Analyst/IT support – Max Griggs
Improvement Facilitators: Nat Joseph, Laura Bryce, Bronwyn Arthur, Kaitlyn Thorne and Dr Liana Green.
Other key stakeholders:
Australian Health Services Research Institute (AHSRI/UOW) partners
- Professor Kathy Eagar –Lead developer
- Centre for Health Services Development RUCs study team (Anita Westera, Carol Loggie, Rob Gordon)
- Palliative Care Outcomes Collaboration Pilot team (Assoc Professor Barbara Daveson, Sabina Clapham, Jane O’Connell, LeTisha Kable, Martin Kultner, Tania Pidgeon, Gaye Bishop, Clare Christianson, Dr Malene Ahern, Dr Pippa Blackburn, Walt Davis, et al.)
- Centre for Health Research Illawarra Shoalhaven Population (Assoc Professor Judy Mullen, Dr Esther Davi, David Webster, Dr Victoria (Tor) Westley-Wise)
- Health Service and community stakeholder representatives
• Paul Sadler Consultancy
• ACHs involved in the initial PCOC Wicking pilot and the multiple ACH staff and organisations who have provided ongoing feedback, advice, support and encouragement.
• Australian Government Department of Health and Aged Care -Funders
Why PACOP was recognised
PACOP has emerged as a pivotal program addressing the critical need for enhanced palliative and end-of-life care in residential aged care.
Through a comprehensive approach involving standardised assessments, education, and benchmarking, PACOP has successfully improved care outcomes and empowered staff and residents in aged care settings.
Ongoing evaluation and stakeholder collaboration ensure the program’s continued effectiveness and scalability – a key requirement of the entry criteria!
