Palliative Care in Rural Australia: Involving the Community in Multidisciplinary Coordinated Care

Abstract

This paper describes the process and outcomes of a project aimed at promoting community based multidisciplinary coordinated palliative care services in rural Australia. In preliminary health service needs assessment in rural Tasmania, key health workers appealed for additional information, support and education in palliative care. They expressed a preference for this education to be delivered locally to strengthen existing knowledge in communities and to take into account contextual factors. The project aimed to enhance skills available in rural communities by involving key stakeholders including formal and informal carers, volunteers, clergy, pharmacists, community nurses and general practitioners. The project objective was to strengthen existing expertise and commitment in rural communities, enabling service providers to respond to community needs in a sustainable way. This was achieved by facilitating options for sustainable linkages and ongoing support and through outreach programs from urban Palliative Care Units. An important element in this was the Tasmanian Telehealth network, which harnesses videoconferencing, digital diagnostic equipment and image transmission technologies to offer access to healthcare services to Tasmania's rural and isolated communities. The process centred on workshops facilitated by a multidisciplinary team, which provided information about the core components of palliative care. The paper reports on the responses of health professionals and community participants to the workshops.

Palliative care professional education via video conference builds confidence to deliver palliative care in rural and remote locations

“…Palliative care is an integral part of rural health care practice, but research about rural palliative care remains limited [ 1 ]. People living in rural and remote areas of Australia [ 2 - 4 ] and those from non-mainstream backgrounds, such as Indigenous Australians, particularly those living in remote areas [ 5 ] are disadvantaged in accessing palliative care. While some of this may be due to distance from urban specialist services, rural health care practitioners may also have limited experience and skills in the delivery of palliative care [ 2 ].…”

“…People living in rural and remote areas of Australia [ 2 - 4 ] and those from non-mainstream backgrounds, such as Indigenous Australians, particularly those living in remote areas [ 5 ] are disadvantaged in accessing palliative care. While some of this may be due to distance from urban specialist services, rural health care practitioners may also have limited experience and skills in the delivery of palliative care [ 2 ]. Robinson et al [ 1 ] considered the most significant factor hindering the provision of high quality care in rural areas was lack of role preparation as most nursing and medical undergraduate courses do not cover this area of care adequately.…”

“…The recommended educational strategies for these groups include conducting a needs analysis and designing context specific programs [ 3 , 26 ]. Local delivery of education which takes into account contextual factors can strengthen existing community expertise and commitment, enabling service providers to respond to community needs in a sustainable way [ 2 ]. With technological improvements and reduction in infrastructure costs during recent years, videoconferencing has become a widely accepted, cost effective medium for clinical consultations [ 27 , 28 ] and health care education in Australian and internationally [ 29 - 31 ].…”

The Griffith Area Palliative Care Service (GAPS): an evaluation of an Australian rural palliative care model

“…Implementation of a computerised patient information management system. 9. Expanded professional education for staff.…”

“…Enhancing skills available in rural communities with outreach programmes and use of telemedicine (9).…”