Evaluation of a toolkit resource package to support positive workplace behaviours in relation to quality end-of-life care in Australian hospitals

Abstract

BackgroundThe study aimed to determine the effectiveness of an action-orientated toolkit in supporting behaviour change in relation to quality end-of-life care in acute hospital settings. The toolkit was developed to complement a programme of online end-of-life care education.MethodsA toolkit was developed from an international review of peer-reviewed literature on end of life. Toolkits were distributed (n=428) to Australian healthcare professionals over a 4-week period. An online survey was sent to all recipients; 65 responses were received (16% response rate, excluding emails returned as undeliverable). Semistructured interviews (n=10) were conducted using purposeful sampling to ensure a range of views were captured. The focus of the evaluation was on investigating (1) users’ responses to the toolkit and (2) individuals’ reported behaviour change.FindingsThe toolkit was well received by users who reported increased confidence in communication around end-of-life matters. 59.3% of users reported making a behaviour change over the previous 4 weeks; 70.8% of those who had not made a change reported they intended to in the near future. Against expectation, the toolkit’s appeal went beyond its intended audience in acute hospital settings, for example, personal care workers in aged care settings.ConclusionsDespite study limitations (self-report of a small, self-selected sample), these early findings suggest that the toolkit has potential to positively impact on end-of-life care practices. However, additional evaluation is needed to determine whether such a toolkit can positively impact on practice and on patient experience at the end of life.

Improving quality in hospital end-of-life care: honest communication, compassion and empathy

“…Education is vital, however alone it does not bring about change 41. For EOLE, this is achieved in part by offering the education in conjunction with an implementation toolkit that provides learners with practical ways in which they can change their practice in an ongoing manner 14. Whether this change is sustainable in practice is still yet to be understood and this is an area open to further investigation.…”

“…The project, conceptualised and developed at Flinders University South Australia, in effect, operationalises the essential elements identified in the Consensus Statement and builds on the work already identified. EOLE provides free evidence-based, peer-reviewed online learning modules to help build the capacity of HCPs in Australian hospitals 14. The modules are designed for doctors, nurses and allied health professionals (AHP) working in acute care settings and cover: dying (a normal part of life), patient-centred communication and shared decision-making; recognising end of life; goals of care; teamwork; and responding to concerns.…”

End-of-Life Care in Acute Hospitals: Practice Change Reported by Health Professionals Following Online Education

“…[23]. An implementation toolkit was also developed to facilitate changes in practice more broadly [10], all intended to allow the tracking of potential practice change.…”

“…In 2015, the Australian Commission on Safety and Quality in Health Care (ACSQHC) released the National Consensus Statement on Essential Elements for safe and high-quality end-of-life care (The Consensus Statement) [ 9 ], containing recommendations for clinical practice in end-of-life care. End of Life Essentials (EOLE) ( ), an Australian Government-funded project, developed online education modules based on the Consensus Statement [ 9 ], which addresses the educational needs of health professionals in acute hospitals [ 10 ]. Six free online education modules for health professionals working in acute hospitals were launched in the latter part of 2016: Dying, a normal part of life; patient-centred communication and decision-making; Recognising the end-of-life; Planning end-of-life care—Goals of care; Teams and continuity for the patient; and, Responding to concerns.…”

“…For example, at the end of each EOLE module, a question was posed: “ Tomorrow, the one thing I can change to more appropriately provide end-of-life care is… ” [ 23 ]. An implementation toolkit was also developed to facilitate changes in practice more broadly [ 10 ], all intended to allow the tracking of potential practice change.…”