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Quality Improvement in Paediatric Palliative Care

 

QuoCCA Project Learnings for Workforce Education

What have we learnt about providing education to health professionals regarding paediatric palliative care?

Based on the QuoCCA Project Logic Model, an evaluation plan was formulated to measure the impacts and outcomes of the national paediatric palliative care education from the perspective of health professionals and families involved. These results informed further development of the QuoCCA education and were published to allow education programs in other services and other specialties to benefit.

 

Impacts

Evaluation findings have shown a significant increase in knowledge and confidence of participants in QuoCCA education for all measures, increasing with greater dosages of education (both in length and repetition of exposure to education sessions). These results encouraged the continuation of the provision of education to novice and experienced professionals who care for children with a life-limiting condition. Educators found that education was more effective when tailored to the needs of the audience, was interactive, and included story-telling, case studies, and parent experiences.

Slater PJ, Herbert AR, Baggio SJ, et al. Evaluating the impact of national education in pediatric palliative care: the Quality of Care Collaborative Australia. Adv Med Educ Pract. 2018; 9:927-941. DOI: https://doi.org/10.2147/AMEP.S180526

 

Long term improvements in knowledge and confidence

The increase in knowledge and confidence provided through QuoCCA education was found to be sustained in the long term, with improvements to clinical practice and care of patients of participants.  Respondents particularly mentioned improvements in awareness of the network of care, the practical management of patients and communication skills. Reflection on clinical practice, in a proactive clinical learning environment, enabled the translation of education into improvements to the quality of PPC.

Slater PJ, Osborne CJ, Herbert AR. Ongoing value and practice improvement outcomes from pediatric palliative care education: The Quality of Care Collaborative Australia. Adv Med Educ Pract. 2021;12:1189-1198. DOI: https://doi.org/10.2147/AMEP.S334872

 

What we learnt from the experience of staff

Interviews with education participants emphasised the value in building capability through effective and accessible education, developing inter-professional partnerships in the complex network of care, sustaining wellbeing, and learning from children and families in providing family centred care. QuoCCA had continued to enhance capability through mentoring with ongoing collegial support and guidance. 

Dedicated educator roles in tertiary PPC services enhanced workforce capability through education and ongoing mentoring, building collaborative relationships between the complex network of care providers for children with a life-limiting condition and their families, and improved quality and access to PPC.

Donovan LA, Slater PJ, Baggio SJ, McLarty AM, Herbert AR. Perspectives of health professionals and educators on the outcomes of a national education project in pediatric palliative care: The Quality of Care Collaborative Australia. Adv Med Educ Pract. 2019;10:949-958. DOI: https://doi.org/10.2147/AMEP.S219721

 

What we learnt from the experience of families

Families appreciated the network of care facilitated through QuoCCA, regardless of their residential location. Parents caring for a child with an LLC described significant personal, familial, social and existential adjustments.

Learning from lived experience in PPC education enhances the preparedness of generalist health and social care professionals to care for a child and their family throughout their various life transitions and facilitate the goal to remain at home within their community for as long as possible. Education in PPC is an imperative component of service models, enabling regional services to gain confidence and capability in the context of a dying child and their family, empowered and informed through the voice of the family.

Donovan LA, Slater PJ, Delaney AM, Baggio SJ, Herbert AR. Building capability in paediatric palliative care and enhancing education through the voice of parents: the Quality of Care Collaborative Australia. Palliat Care Soc Pract. 2022;16:1-14. doi:10.1177/26323524221128835

 

What we learnt from the experience of specialist trainees

Having supported the regional and community services to provide care close to families’ homes, QuoCCA also sought to maintain the sustainability of tertiary services where the specialist PPC services were located. Medical Fellows and Nurse Practitioner candidates were recruited as trainees to develop expertise in PPC. The service leadership and collaborative interdisciplinary team supported various modes of education and mentoring which developed the trainees’ PPC clinical skills, their general clinical practice (including communication, empathy and holistic care), as well as their personal wellbeing and career development.

Slater PJ, Herbert AH. Education and mentoring of trainee specialist pediatric palliative care medical and nursing workforce: the Quality of Care Collaborative Australia. Adv Med Educ Pract. (under review).

Slater PJ, Herbert AH. Supporting the wellbeing of specialist pediatric palliative care medical and nursing trainees: the Quality of Care Collaborative Australia. Adv Med Educ Pract. (under review)

Page updated 29 November 2022