This presentation was originally presented at the Palliative Care Western Australia conference on 5 Oct 2012.

1. Evidence, Standards and Outcomes:
Taking a leadership role in palliative
care
Tieman JJ, Rawlings D, Mills S, Banfield M
PCWA Conference, October 2012

2. Overview of session
•Quality Issues: Drivers, evidence, approaches
•Working Together: CareSearch, NSAP, PCOC
•Six Questions

3. Drivers for change
•Health care variability
• Not receiving recommended care
• Fragmented care
•Demand issues
• Increased demand
• Changing patterns of need
•Dynamic evidence base
•Costs and resources
•Health information technology

4. QI and Evidence
•EBM/EBP: Evidence to inform quality care
•Evidence as content in QI processes
•Value add between EBM and QI
•Emerging evidence of value of QI
•QI processes as a source of new evidence

5. Working Together Partnership
•CareSearch, NSAP, PCOC
•MOU signed in 2010
…common interest, informed by
different but aligned perspectives,
in improving palliative care in Australia
by upskilling palliative care services,
facilitating quality improvement and
encouraging the use of evidence in practice.

6. Working Together: NSAP, PCOC, CareSearch
All programs funded by Department of Health and Aging
All work with Palliative Care Services to improve Service quality
STANDARDS
NSAP: National Standards Assessment Program
• Services complete a self assessment snapshot
every 2 years against the standards
• Create and implement a quality improvement
action plan, based on these results

7. OUTCOMES
PCOC: Palliative Care Outcomes Collaborative
Utilises standardised validated clinical assessment
tools to benchmark and measure outcomes in
palliative care
EVIDENCE
CareSearch:
Australia’s Palliative Care knowledge base
Latest resources and evidence

8. Working Together Projects
•Integration of current activities
•Identification of services
•Working Together Change Framework
• WTCF Workshops
• WTCF Study
•Change Management Hub:
• Tools registry
• QI searches

9. How do we work together?
Evidence Sources for NSAP Self Assessment PCOC CareSearch
PCOC: Palliative Care Outcomes Collaboration
Outcomes can be used as an evidence source for your
NSAP Self Assessment
CareSearch NSAP
Provides links to quality tools which can be used for
NSAP Self Assessment
Quality Improvement Results and latest evidence for PCOC NSAP CareSearch
development of a Quality Improvement Action Plan
PCOC Report
NSAP Results & Key Improvement Areas
CareSearch Evidence Quality
Improvement
Action Plan

10. Working Together Change Framework

11. Question 1:
•Think about how you know there is a
Is there a
problem. Describe the problem for others. problem?
Be specific about the problem.
•Outline how big a problem it is and how
it affects your work and your patients.
•You also need to consider whether it is a
problem that you can solve.

12. Question 2:
•Do some analysis on possible causes
• Service characteristics What is
• Patient population causing the
• Feedback from patients/staff problem?
•Check to see if there are reports or articles
on similar problems
•Speak with other services about whether similar issues

13. Question 3:
•Check for evidence on the specific issue.
Find out if there is evidence for new or Is there
different approaches. evidence
about what
•Find out if there are tools or measures you to do?
could use.
•Review what is effective in change management.
Think if some of these strategies could be used in your plan.

14. Question 4:
•Check your plan indicates
• Who
Does your
• What
plan address
• By when the issues?
•Make sure your plan is suitable for your service.
•Identify and include measures that can be used
to show if things are changing

15. Question 5:
•Monitor what is happening as you Were you
implement the plan. able to
implement
•You may need to vary your plan. Things change. your plan?
People change. New information may emerge.
•Keep a note of why something changed and
what you did in response.

16. Question 6:
•Review everything that happened. Have you
Just because you did something reviewed
does not mean that what you wanted to, what you
or expected to, happen actually did happen. did?
•Determine if the problem has been solved.
Think about whether a different approach is needed.

17. WTCF Workshop Evaluation
•Ethics received for evaluation study
• Post-workshop questionnaire
• Follow up survey (8 weeks)
•Objectives
• To determine Workshop participants’ responses to the
Working Together Change Framework
• To evaluate the effectiveness of the Workshop content and
format
• To determine if participation in the Workshop led to
change activity in the service

18. Using the Working Together Group
•Services can identify quality improvement
opportunities through PCOC, NSAP processes
•Evidence summaries on priority areas available
through CareSearch
•Workshops and projects to build knowledge and
expertise in QI

19. CareSearch, NSAP and PCOC are funded by the Australian
Government Department of Health and Ageing.