Clinical resources, training and education

Ready for Community Palliative Care is an online resource of the Victorian Department of Health based on work undertaken by a working party of the Victorian Palliative Care Clinical Network (PCCN).

The resource supports acute hospital staff in their discharge planning for patients who are in the last twelve months of life. Patients may be stable, deteriorating, unstable or actively dying.

The aim of the resource is to make discharge safe and secure for patients, families and carers, whether it is to the person’s home, residential aged care or a disability service.

It includes sections on:

• Ready for community palliative care – in context
• The last twelve months of life
• Advance care planning
• Discharge planning at end of life
• Referring to community services
• Allied health and successful discharge
• Actively dying and wanting to be at home
• Carers
• No nominated carer
• Anticipatory medicines
• General practitioners
• Navigating community services

Click here for more information

Essential elements of end of life care is an online resource of the Victorian Department of Health (DOH) based on work undertaken by a working party of the Victorian Palliative Care Clinical Network (PCCN).

The resource is designed to assist acute health services to operationalise the National consensus statement: essential elements for safe and high-quality end-of-life care.

It is a resource for boards, executives, managers and clinicians of all disciplines.

The resource includes sections on:

• Patient centred care
• Teamwork
• Goals of care
• Using triggers
• Responding to concerns
• Leadership and governance
• Education and training
• Supervision and support
• Evaluation and feedback
• Supporting systems

Click here for more information.

The mission of the non-profit Australian Centre for Grief and Bereavement is to build the capacity of individuals, organisations and communities in order to enhance well-being following adverse life events. The Centre is a statewide service with an office located in Mulgrave, Melbourne. The Centre receives funding from the Victorian Department of Health and Human Services as a statewide specialist bereavement service.

Services and resources include:

• Education and training opportunities for health professionals, students, volunteers and any other individual or agency desiring to enhance grief and bereavement knowledge and practice.
• Bereavement support for individuals, children and families who need assistance following the death of someone close to them, including counselling, support groups, information resources and remembrance events. In addition, the service provides advanced training for bereavement counsellors by providing a supervised internship for experienced practitioners.
• Practitioner Certification: The Certified Bereavement Practitioner (CBP) Program.
• Publications and resources, including Grief Information Sheets and Grief Matters: The Australian Journal of Grief and Bereavement.

Click here for more information.

The Australian Commission on Safety and Quality in Health Care (the Commission) was established in 2006 by the Australian, state and territory governments to lead and coordinate national improvements in safety and quality in health care. The Commission’s strategic priorities are in the areas of: patient safety; partnering with patients, consumers and communities; quality cost and value; supporting health professionals to provide safe and high-quality care.

Work program areas include:

• End of life care
• Recognising and responding to clinical deterioration

Click here for more information.

The Australian Institute of Health and Welfare (AIHW) is an Australian Government body with the formally defined purpose to “create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians”. The AIHW’s palliative care data includes a range of national and state/territory statistics. Click here for more information.

The  bereavement support standards document was developed by the Australian Centre for Grief and Bereavement in partnership with the Centre for Palliative Care with funding and other support provided by the Victorian Department of Health.

The bereavement support standards are designed for use by professionals working in all Victorian government-funded adult specialist palliative care services, including community, inpatient, acute and consultancy services, to assist carers and bereaved individuals with elevated risk of developing prolonged or complicated grief or with current psychosocial and/or spiritual distress.

The standards document includes a section on factors impacting on grief reactions (risk factors and factors that enhance resilience) along with a glossary and resource listing.

A copy of the standards can be found on various websites, including the Australian Centre for Grief and Bereavement. Click here for more information.

CareSearch is an evidence palliative care based website developed at Palliative and Supportive Services, Flinders University funded by the Australian Government. CareSearch includes information for health professionals, aged and other community services workers, academics, researchers and for people with a life limiting illness and their carers and family.

CareSearch includes information for:

• People with a life limiting illness and their carers, family and friends
• General Practitioners (GPs)
• Residential Aged Care staff
• The PalliAGED website (developed by CareSearch) is an online evidence-based guidance and knowledge resource for palliative care in aged care. It incorporates and updates the evidence-based information previously contained in the Guidelines for a Palliative Approach in Residential Aged Care (APRAC) and the Guidelines for a Palliative Approach for Aged Care in the Community Setting (COMPAC) and includes access details for smartphone applications for nurses and GPs, palliAGEDnurse and palliAGEDgp.
• Nurses
• Allied Health
• Researchers

Click here for more information.

Latest resources from CareSearch

CareSearch’s new Evidence and Translation Centre now provides access to an expanded and upgraded range of evidence resources for health professionals including clinical evidence summaries, links to palliative care guidelines, and relevant palliative care tools for use in practice and research. Click here to access the Evidence Centre.

There are also two new training resources. The first focuses on helping health professionals develop their knowledge and skills in evidence-based practice. The second set of resources looks at translation and implementation of evidence for use in the workplace and in health services.

CareSearch: Palliative care information hub developed with nurses for nurses

CareSearch has recently re-developed the Nurses Hub to provide even more practical and actionable support for nurses new to palliative care as well as for those with experience. This work was guided by a representative group of nurses from community care, aged care, acute care, rural and remote, and professional representation sectors. Now updated and expanded, visit the CareSearch Nurses Hub for more on:

• Palliative Care Nursing: understand the what, where and who of palliative care nursing practice
• Communication: explore ways to gather and share information respectfully and compassionately
• Assessment: find out how to recognise needs and monitor for changes
• Planning and Coordinating Care: learn how to involve individuals and teams in planning and care coordination for current and future needs
• Clinical Care: find practical information on responding to physical and psychosocial needs including:
  • information on how to recognise, assess, and manage ten commonly experienced symptoms and issues
  • My CPD reflections forms developed to help nurses record their learning activity across the ten symptoms
• The Dying Patient: understand how to recognise and manage imminent death and address after-death care
• Loss, Grief, and Bereavement: learn how to support those going through grief and bereavement
• Tools for nurses in palliative care: a range of forms, checklists, and tools to assist in providing palliative care.
• Palliative Perspectives blog.

Read more about nurses providing care at the end of life in HealthTimes.
For more information on this project and resource please contact .

The Centre for Palliative Care is part of St Vincent’s Hospital Melbourne and is a Collaborative Centre of The University of Melbourne. The Centre’s website includes:

• List of publications and current research.
• Community resources section.
• Education and learning section with professional development and training opportunities.

The Centre’s education and training opportunities include:

• Access to the hot topic online webinars
• Victorian Palliative Medicine Training Program (VPMTP)
• Victorian Palliative Care Nurse Practitioner Collaborative (VPCNPC)
• The Program of Experience in the Palliative Approach (PEPA)
• The Centre for Palliative Care

A project of Flinders University, End-of-life Essentials provides e-learning and resources for doctors, nurses and allied health professionals to improve the quality and safety of end of life care in hospitals.

The content of End of Life Essentials has been informed by the National Consensus Statement ‘Essential elements for safe and high-quality end-of-life care’ of the Australian Commission on Safety and Quality in Health Care and is relevant to implementation of the end of life care components of the Commission’s National Safety and Quality Health Service Standards. Click here to access these education modules.

HealthPathways Melbourne, an initiative of the North Western Melbourne Primary Health Network (NWMPHN) and Eastern Melbourne Primary Health Network (EMPHN) is an online portal designed to be used at the point of care by GP teams working in the northwest and eastern regions of Melbourne.

HealthPathways aims to guide best-practice assessment and management of common medical conditions and includes detailed information and links on palliative care topics.

Click here for more information.

Victoria’s Integrated Cancer Services (ICS) are the Victorian Cancer Clinical Network and comprise clusters of hospitals and associated health services that deliver care for people with all types of cancers within a geographic area, including public hospitals, community-based services, general practitioners and other primary health organisations, private hospitals and supportive care services.

Within the context of the Victorian Cancer Plan 2020-2024, the role of the ICS is to build relationships, implement best practice models of care, improve the effectiveness of cancer care and monitor systems and processes to improve performance.

Click here for more information about Victorian Integrated Cancer Services.

Following the Victorian Parliament’s passing of The Access to Medicinal Cannabis Act 2016, The Office of Medicinal Cannabis within the Department of Health has been established to oversee the operation of Victoria’s medicinal cannabis framework.

From a patient/clinician perspective, it is necessary to understand how the Victorian legislation interacts with national drug laws regarding the cultivation, manufacture and supply of medicinal cannabis products. These national laws and regulations are overseen by the Australian Government Office of Drug Control and the Therapeutic Goods Administration (TGA).

In summary:

• All legal pathways to accessing medicinal cannabis require the support and monitoring of a treating medical team, who need to seek and obtain the appropriate approvals on behalf of the patient.
• The key gateways to accessing medicinal cannabis are the Special Access Scheme (SAS) and Authorised Prescriber (AP) processes of the TGA. See the TGA’s ‘Access to medical cannabis products in Australia: Resource for doctors’, for a one page diagrammatic summary.
• All patients eligible for the new Victorian scheme will still need to go through the TGA approvals process (i.e. the Victorian and Australian Government schemes, although independent, operate together in a complementary way).
• The initial priority patient group for access to medicinal cannabis under the Victorian legislation is children with severe intractable epilepsy. Eligible patient groups under the Victorian legislation may be expanded in the future based on the advice of an Independent Medical Advisory Committee.
• The TGA’s SAS and AP processes are not restricted to the Victorian eligible patient group – a doctor may apply to the TGA for special access for patients with any indication for whom they believe treatment with medicinal cannabis is appropriate.
• The TGA may also allow access to medicinal cannabis for the purposes of clinical trials, which may be conducted to develop an evidence base to support safety and efficacy of medicinal cannabis.

In addition to considering types of patients eligible for medicinal cannabis, both the national and Victorian legislation include a considerable focus on processes for the cultivation and supply of medicinal cannabis. This includes importation and the production of medicinal cannabis in Australia. For example, under the TGA SAS/AP processes, if stock is available in Australia (Step 3A in ‘Access to medical cannabis products in Australia: Resource for doctors’) access tends to be significantly quicker and easier than if product must be imported (Step 3B).

Accordingly, the Victorian legislation is partly about encouraging the development of a new local/Victorian supply of medicinal cannabis products and reducing the need to source imported products.

In summary, from a Victorian scheme ‘supply of product’ perspective:

• Once a local/Victorian supply of medicinal cannabis is established, the Victorian legislation directs that access to this supply is restricted to the groups specified as eligible (currently children with severe intractable epilepsy).
• Other groups of people considered in need of medicinal cannabis by their doctors will not be eligible to access the local/Victorian manufactured supply, except in exceptional circumstances. Rather, via the TGA SAS/AP processes referenced above, doctors will need to access supply from sources other than the Victorian scheme.
• Note: The doctors of Victorian scheme eligible children also need to gain approval via the TGA SAS/AP processes before being able to access the local/Victorian product.

The Frequently Asked Questions (FAQ) of the DOH Office for Medicinal Cannabis includes further information on a range of topic.

Click here for more information.

The National Consensus Statement ‘Essential elements for safe and high-quality end-of-life care’ was published in 2015. The Consensus Statement aligns with the Commission’s National Safety and Quality Health Service Standards.

Click here for more information about the National Consensus Statement: Essential for safe and high quality of end of life care.

Click here for information on end of life care published by the Australian Commission on Safety and Quality in Health Care.

The Victorian Paediatric Palliative Care Program (VPPCP)

The VPPCP section of the Royal Children’s Hospital website provides a range of information and links about paediatric palliative care, including ‘Basic Symptom Control in Paediatric Palliative Care’, a clinical tool published by the UK non-profit organisation Together for short lives.

Click here for more information about the Royal Children’s Hospital Palliative Care Program.

Basic Symptom Control in Paediatric Palliative Care (a worldwide clinical tool published in the UK)

Basic Symptom Control in Paediatric Palliative Care is a clinical tool published by the UK non-profit organisation Together for short lives.

https://www.betterhealth.vic.gov.au/health/servicesandsupport/Palliative-care-for-the-LGBTI-community. Click here for resources.

Quality of Care Collaborative for Australia in Paediatric Palliative Care (QuoCCA).

Further information and training about paediatric palliative care is available as part of the Australian Government funded project, Quality of Care Collaborative for Australia in Paediatric Palliative Care (QuoCCA). Click here for more information.

National consensus statement on essential elements for safe and high-quality paediatric end-of-life care

The National Consensus Statement ‘Essential elements for safe and high-quality paediatric end-of-life care’ was published in 2016 by the Australian Commission on Safety and Quality in Health Care. The Consensus Statement aligns with the Commission’s National Safety and Quality Health Service Standards but provides recommended, rather than mandatory, practice. It also aligns with the National consensus statement: essentials elements for safe and high-quality end-of-life care and the National consensus statement: essential elements for recognising and responding to acute physiological deterioration. It is intended that these documents be applied together. Click here for more information.

After the Loss of a Child: A Resource for Parents of Children in Palliative Care

After the Loss of a Child: A Resource for Parents of Children in Palliative Care is a booklet published by the Australian Centre for Grief and Bereavement. It is designed for parents of children in palliative care, but is also a useful resource for any parent who experiences the loss of a child.

The booklet looks at common issues and processes occurring both before and after the death, and provides information and helpful tips for navigating the grief experience of parents and families both immediately and in the long term. Click here for booklet.

The “I’m a health professional” section of the website of Palliative Care Australia has a range of information and links for health professionals involved in supporting people with life-limiting illness and their families. Click here for more information.

The Palliative Care Clinical Network (PCCN) is one of 10 clinical networks that are part of The Victorian Government’s Safer Care Victoria initiative.

The PCCN provides clinical leadership in the implementation of policy directions and program initiatives in Victoria and undertakes projects to enhance the availability of clinical tools and resources for palliative care.

The Palliative Care Clinical Studies Collaborative (PaCCSC) is an Australian Government national research network run by Flinders University that aims to:

• Generate high quality research evidence to support the use of medicines and other interventions at the end of life to better manage or alleviate symptoms in patients such as: pain; confusion; breathlessness; appetite; and gastrointestinal problems including nausea; bowel obstruction; and constipation.
• Build capacity within the health workforce in the conduct of high quality clinical research in patients nearing the end of life and the translation of research results into clinical practice.

PCC4U is an Australian Government funded project led by Queensland University of Technology in collaboration with the Queensland Government, Flinders University and Curtin University of Technology. It promotes the inclusion of palliative care education as an integral part of all medical, nursing, and allied health undergraduate and entry to practice training, and ongoing professional development. Click here to view website.

The Palliative Care Outcomes Collaboration (PCOC) is a national program run by the Australian Health Services Research Institute (AHSRI) of the University of Wollongong. PCOC utilises standardised clinical assessment tools to measure and benchmark outcomes in palliative care. Participation in PCOC is voluntary and can assist palliative care service providers to improve practice. This PCOC website outlines how this is achieved through an outcome improvement framework which is designed to:

• provide clinicians with the tools to systematically assess individual patient experiences using validated clinical assessment tools,
• define a common clinical language between palliative care providers to support assessment and care planning,
• facilitate the routine collection of national palliative care data to drive quality improvement through reporting and benchmarking,
• provide regular patient outcomes reports and workshops to facilitate service-to-service benchmarking, and
• support research using the PCOC longitudinal database.

The PCOC data set includes the clinical assessment tools: Palliative Care Phase, Palliative Care Problem Severity Score (PCPSS), Symptom Assessment Scale (SAS), Australia-modified Karnofsky Performance Status (AKPS) Scale and Resource Utilisation Groups – Activities of Daily Living (RUG-ADL).

Participation in PCOC can also provide evidence for organisations and palliative care services to meet core actions in the National Safety and Quality Health Service Standards.

Web: Palliative Care Outcomes Collaboration (PCOC) homepage

The Program of Experience in the Palliative Approach (PEPA) is a nationally funded program run in Victoria by the Centre for Palliative Care.

Victorian PEPA aims to improve the accessibility of quality palliative care in the community by increasing the skills and confidence of health professionals who are caring for people with serious illness, and their families.

PEPA activities include:

• Workshops on the palliative approach
• Supervised clinical placements
• Post-placement support activities

Click here to view website.

Safer Care Victoria is the peak state authority for leading quality and safety improvement in healthcare. Safer Care Victoria oversees and supports health services to provide safe, high-quality care to patients “every time, everywhere”.

Created in response to the recommendations within the report Targeting Zero: supporting the Victorian hospital system Safer Care Victoria works to eliminate avoidable harm and strengthen quality of care.

Staffed and led by clinicians and researchers, Safer Care Victoria provides secretariat support for the Victorian Clinical Council and works closely with the Victorian Agency for Health Information and the Department of Health .The operation of the Palliative Care Clinical Network (PCCN) transferred to Safer Care Victoria in 2017. Click here for more information.

The Supportive and Palliative Care Indicators Tool (SPICT™) was developed by the University of Edinburgh to:

• Help identify people whose health is deteriorating
• Assess them for unmet supportive and palliative care needs
• Plan care

The SPICT™ includes clinical indicators for: cancer; dementia/frailty; neurological disease; heart/vascular disease; respiratory disease; kidney disease; liver disease; other conditions.

It is referenced as part of the Victorian Department of Health (DOH) online resources Ready for Community Palliative Care and Essential elements of end of life care.

The SPICT™ can be downloaded free of charge via a registration process. Click here for more information.

Funded by the Victorian Department of Health and run as part of the Centre for Palliative Care, the Victorian Palliative Medicine Training Program (VPMTP) aims to build and sustain a high quality palliative medicine workforce in Victoria. This includes providing palliative care specialists, as well as doctors from other specialities, with the necessary knowledge and skills to practice palliative medicine as part of their clinical workload. VPMTP runs a range of workshops and mentoring programs, along with advanced specialist training in palliative medicine. Click here for more information.

This package has been developed by the Southern Metropolitan Palliative Care Consortium and is designed with summary information to help staff care for people with PD in the terminal stage, and their family/carers. It includes contact details for further help and information. The example care plan is designed to be a prompt for the kinds of issues that should be included in a comprehensive care plan.

Click here to access the package.