Original Research
Palliative and end-of-life care is everyone's business – a mapping study to guide a palliative approach in far west New South Wales, Australia
AUTHORS
Emily Saurman1 PhD, Research Fellow –Rural Health *
David Lyle2 PhD, Head of Department
Sarah Wenham3 PhD, Specialist Palliative Care Physician
Melissa Cumming4 Master of Palliative Care, Director Cancer Services, Innovation (Rural) & Palliative Care
AFFILIATIONS
1, 2 Broken Hill University Department of Rural Health, University of Sydney, Corrindah Court, PO Box 457, Broken Hill, NSW 2880, Australia
3, 4 Far West Local Health District, Broken Hill Health Service, Thomas Street, Broken Hill, NSW 2880, Australia
ACCEPTED: 14 October 2018
early abstract:
Introduction: All healthcare providers can influence the delivery and outcome of a palliative approach to care, ensuring that everyone has “equitable access to quality care based on assessed need as they approach and reach the end-of-life”. This study 'mapped' the delivery of palliative care in far west New South Wales (NSW), Australia with the objective to:
i. identify who was involved in providing such care in the FWLHD, how they connect, and any gaps in the network,
ii. describe what care was provided and identify any challenges to care provision.
The mapping process and outcomes can be used to guide the implementation of new models of care by building on the localised knowledge of current networks, provision of care, and challenges.
Methods: Semi-structured interviews with members of the specialist palliative care service (SPCS) and generalist healthcare providers within the FWLHD. Fifteen interviews were conducted over seven months. Content analyses of interview transcripts identified processes and challenges as well as improvements for care. A network analysis was conducted to identify unidirectional connections and ‘map’ the services.
Results: The vast network demonstrates extensive long-term involvement in palliative care as well as established connections and opportunities for improving communication between the services and providers involved in palliative care. Palliative practice is varied and challenging within the network; challenges include communication, early identification, and education. Mapping the existing networks, resources, and relationships proved invaluable to guide the implementation of a palliative approach to care.
Conclusion: The implementation of a palliative approach, as with any service model, requires agreement and engagement across relevant healthcare organisations, services, and providers. Mapping and understanding the network of providers (and organisations) that support health care delivery before implementing new models of care will identify strengths and gaps within the network. This knowledge will then support new and integrated connections that enhance the provision of care so that it is acceptable, fit for purpose, and regionally responsive.