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A team approach to palliative care clinical audits

Palliative care clinical audits held in the Southern Fleurieu Region, including Kangaroo Island (South Australia), use a multidisciplinary approach to review difficult cases.

The quarterly audits have been introduced as part of the federally-funded General Practice Network South (GPNS) Rural Palliative Care Project, in conjunction with local health professionals.

Initial consultation recognised that existing local multidisciplinary team meetings lacked a specific focus on palliative patients, did not always include the treating GP or have regular input from a palliative specialist from Adelaide.

The initial audit held in July 2009, reviewed three cases provided by local GPs and palliative care nurses. All presented challenging aspects including less than optimal symptom control or an issue with communication or Advance Directives (legal documents that allow you to convey your decisions about end-of-life care ahead of time). Discussion included a brief preview of the case from the health professional/s involved and an outline of best practice and care standards provided by a palliative specialist from the Southern Adelaide Palliative Service. Together with identifying two to three key learning points, the group also identified actions or systemic changes that might improve palliative care in the region.

The benefits of this approach include the opportunity for health professionals to share their knowledge and to ask the palliative specialist questions both about the cases being reviewed and the care of current patients.

Evaluations show that participants value the opportunity to build a professional relationship with the palliative specialist from Adelaide and are changing their practice as a result of what they have learned at the audit sessions. A summary of each audit is also distributed to interested stakeholders across the region.

Subsequent audits in October 2009 and February 2010 have attracted a growing and diverse range of health professionals including GPs, palliative care and community health nurses, pharmacists, medical students and local health service managers. Staff from local residential aged care facilities have also expressed interest in attending.

For further information Helene can be contacted on P: 08 8552 7981 or E: helene.hipp@gpns.org.au