To understand the epidemiology and complexity of patients receiving community palliative care from Silverchain in Western Sydney and determine predictors of key outcomes to inform service delivery.

Silverchain introduced a specialist community palliative care service in the Western Sydney Local Health in 2017. The area is home to one million people with high levels of cultural diversity and faces a growing burden of disease and rising demand for health services. 

Data was extracted electronically for patients receiving care within 2017 to 2022.  Variables include patient demographics, diagnosis, symptoms, service provision, PCOC variables, and outcomes. In addition, manual data extraction was used to extract information on comorbidities, frailty, and current patient medications on admission to the palliative care service on a random sample (n=480) of patients.  Descriptive statistics were derived using standard statistical methods, trends in characteristics overtime and predictors of key outcomes (e.g. death in preferred place) were derived using multivariable regression models. 

Patients demonstrated high complexity with 79% diagnosed with cancer and 21% another life-limiting illness. Patient characteristics on admission included high levels of comorbid conditions (e.g hypertension 41%, diabetes 26%, cardiac arrhythmia 22%, chronic pulmonary disease 21%, ischaemic heart disease 19%), a median of 6 current medications (range 0-23) and high prevalence of frailty (43%).  Additionally, 49% were pensioners, 16% required an interpreter and 36% stated English was a second language. Results from the full analysis will be presented, including predictive modelling.

The End of Life Directions in Aged Care (ELDAC) project funded by the Department of Health and Aged Care aims to improve outcomes for older people and their families at the end of life. Central to the ELDAC model is a national capacity initiative referred to as the Linkages Program. ELDAC Linkages seeks to enhance training for the aged care workforce to improve the quality of, and timely access to, palliative care for older Australians, support development of organisational capabilities to deliver quality palliative care, and establish, maintain, and strengthen linkages across the primary care, aged care, and palliative care sectors. A team of facilitators use a range of evidence-based strategies to support aged care providers to implement quality improvement initiatives and enhance linkages between aged, primary and specialist palliative care providers. To date, over 250 services have participated in the ELDAC Linkages program. Outcomes of the program are measured at the organisational, provider, and client/resident level. These evaluation data indicate that participation in ELDAC Linkages contributes to improved organisational capacity to provide palliative care, enhanced knowledge and confidence of the workforce about palliative care and advance care planning, and improved implementation of palliative care and advance care planning practices.

Introduction: Across the health sector, there is increasing emphasis on the importance of collaborations with people with lived experience. These are exciting times as we know that health policy, services, research or education led by or done in partnership with people with lived experience leads to more relevant outcomes, more effective use of resources, and a more trustworthy health sector. However, as collaborative approaches grow in importance and popularity, so do tokenistic practices, the co-optation of lived experience expertise, and the reproduction and repackaging of power imbalances.

Provide participants with opportunities to engage critically with scholarship and practice in collaborative models beyond lived experience engagement and involvement. 

The co-facilitators will deliver the aims in three phases.

Phase 1 - Collaboration: Approaches to lived experience engagement and involvement, co-design, co-production, and lived experience leadership will be presented. Participants will map their experiences of collaboration onto a model of power-sharing to explore the power imbalances often faced by people with lived experience.

Phase 2 – Organisational readiness: Participants will be asked to brainstorm and share the resources they would need in their own organisations or settings to help support embedding lived experience leadership.

Phase 3 - Implementation: In groups, participants will discuss strategies to challenge the power imbalances faced by people with lived experience in decision-making and agenda-setting roles. 

 

Participants will be able to;

1) Critique current approaches to ‘involving’ people with lived experience in planning and service delivery, developing policy, conducting and dissemination of research.

2) Understand the differences in power-sharing principles across a range of collaboration modes;

3) Describe the power structures at macro and micro levels of palliative care initiatives;

4) Identify opportunities and strategies to act in allyship with people with lived experience in their own workplace/organisations and community.