Addressing the end-of-life actions in the National Safety and Quality Health Service Standards (2nd edn): a national survey
Elise Button A B * , Sara Baniahmadi A , Shirley Chambers A and Patsy Yates A CA Centre for Healthcare Transformation, Queensland University of Technology, Level 7, Q Block, Musk Avenue, Kelvin Grove, Qld 4059, Australia.
B Cancer Care Services, Royal Brisbane and Women’s Hospital, Qld, Australia.
C Faculty of Health, Queensland University of Technology, Qld, Australia.
Australian Health Review 47(5) 574-585 https://doi.org/10.1071/AH22136
Submitted: 27 May 2022 Accepted: 9 August 2023 Published: 14 September 2023
Abstract
To describe current and planned processes and outcome measures to address implementation of the six end-of-life actions in the National Safety and Quality Health Service (NSQHS) Standards (2nd edn) and explore associated barriers and enablers.
This study used an exploratory mixed methods national survey of acute healthcare facilities between September 2018 and March 2019. This study involved public and private facilities (N = 765) that provided end-of-life care, which are required to be accredited to the NSQHS Standards. Participants include those responsible for reporting implementation of end-of-life care actions at a facility providing end-of-life care. Participants were asked what processes and outcome measures were implemented or being planned to address the end-of-life care actions, and the associated barriers and enablers.
Fifty respondents (6.5% response rate) from across Australia contributed data, reporting greater confidence in addressing Actions 5.16: Clinicians have access to Specialist Palliative Care Services; 5.17: Advance care plans can be received from patients and stored in medical records; and 5.18: Supervision and support is available for workforce providing end-of-life care. Barriers associated with the actions that were the most challenging to address included: competing clinical priorities, and insufficient resources to provide best practice end-of-life care; and the burdensome nature of conducting audits. Enablers included: (1) local, jurisdictional, and national strategic plans and policies; (2) support from Specialist Palliative Care Services; (3) access to resources and data; (4) standardised approaches to implementation and measuring outcomes; and (5) clinician, consumer and community engagement and education on end-of-life care.
Enablers and barriers in implementing the six end-of-life care actions were identified. Respondents reported that high-level support and direction, system-wide approaches, practical clinical support, and widespread community and clinician engagement would enable their facility to better address the end-of-life actions.
Keywords: acute care, end‐of‐life care, health services research, mandatory standards, measuring outcomes, national survey, palliative care, quality and safety.
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