• Quality palliative care is evidence based

    Quality palliative care is evidence based

 

Evidence is an important component in providing best practice person-centred palliative care. While our evidence base is growing, we need to ensure that evidence is readily accessible and used so that all Australians affected by life-limiting illness are able to receive the best quality clinical care and service delivery.

People with life-limiting illness or at the end of life often have complex chronic conditions [1] that require comprehensive and ongoing consideration of their physical, psychological, social, emotional and spiritual needs.

To support them to live each moment of their lives as fully as possible, the palliative care that they receive - whether they are at home, hospital, or in an aged care facility - should be quality, person-centred and evidence based. [2] 

Evidence can guide our choice of the most appropriate treatment and services, including support for carers and family members. It highlights the potential benefits and harms of a treatment or intervention, thereby helping us make informed decisions based on the most likely outcomes. [3] 

Calls for embedding evidence in palliative care provision

Evidence is important in providing quality person-centred palliative care. The 2018 National Palliative Care Strategy lists Data and Evidence as one of its goals. It highlights evidence and data collection as integral parts of evaluating services across all care settings, and in continuous quality improvement. [2]

The National Standards released by Palliative Care Australia highlight that the provision of palliative care should be informed by evidence and based on the assessed needs of the person [4] while the new Aged Care Quality Standards cite evidence as a key component of best practice in personal and clinical care. [5]

The Australian Commission on Safety and Quality in Health Care outlines the importance of evidence in shared decision making in the National Consensus Statement: essential elements for safe and high-quality end-of-life care. [6]

Challenges in searching for and applying evidence in palliative care are: Evidence volume increasing exponentially since the last decade, Multiple disciplines need to be covered when searching for evidence on a topic, Appraising quality of evidence can be time consuming, and Need to develop skills in applying evidence into practice.

 

Graph is showing the steady increase of high level publications per year on palliative care.Figure 1: Research publications on palliative are increasing exponentially.

 

 

'All people require evidence-based and person-centred care at the end of their lives'

Department of Health National Palliative Care Strategy 2018 (page 2).

 

Health services are expected to take 'practical steps to keep abreast with new and emerging evidence, and uses the best available evidence to inform clinical practice'

Palliative Care Australia National Palliative Care Standards 2018 (page 16).

 

'Shared decision-making is a critical part of making sure that patients approaching the end of their lives are partners in their own care. It is a process that allows patients, substitute decision-makers, families and interdisciplinary teams to work together to make decisions in the patient’s best interests, based on the best scientific evidence available, the realities of the patient’s clinical condition and treatment options, and the patient’s choices, values and preferences.'

Australian on Safety and Quality in Health Care, National Consensus Statement: essential elements for safe and high-quality end-of-life (page 11).

CareSearch’s important role

CareSearch is an important partner in the palliative care evidence cycle. We identify, appraise, synthesise and disseminate evidence to enable the best possible care for Australians at the end of their life.

We do the hard work of evaluating large volumes of research and evidence covering multiple disciplines to support health professionals in their practice. Our work also offers patients, carers and families trustworthy information to support them in asking questions and making informed decisions.

Evidence resources

For your practice and your service

For patient, carers and families

For GPs

For nurses

For allied health professionals

References

  1. Australian Institute of Health and Welfare (AIHW). Palliative care services in Australia [Internet]. 2019 [updated 2019 May 22; cited 2019 Jun 20]. 
  2. Department of Health. National palliative care strategy 2018. Canberra: Department of Health; 2019 Feb.
  3. CareSearch. CareSearch@10: Making palliative care evidence evident (5.47MB pdf). Adelaide: Flinders University; 2018.
  4. Palliative Care Australia (PCA). National Palliative Care Standards 5th edn (358kb pdf). Canberra: PCA; 2018.
  5. Aged Care Quality and Safety Commission. Guidance and Resources for Providers to support the Aged Care Quality Standards. Canberra: Aged Care Quality and Safety Commission; 2019 May.
  6. Australian Commission on Safety and Quality in Health Care (ACSQHC). National Consensus Statement: essential elements for safe and high-quality end-of-life care. Sydney: ACSQHC. 2015 [cited 22 June 2019].

Page created 26 June 2019