As part of the Comprehensive Palliative Care in Aged Care program in South Australia, Needs Rounds have been trialled in seven private (Eldercare) and fifteen public (Rural Support Services) aged care facilities. Eldercare employed a nurse practitioner led model whilst regional sites engaged more with palliative care medical specialist, GPs and pharmacist. 

-          To evaluate Needs Rounds processes and outcomes including implementation enablers and challenges

-          To compare approaches employed by the two sites.

Methods 

Individual interviews were conducted with executive members, senior nurses, and palliative care specialists in Eldercare (n=6) and Rural Support Services (n=4). We also facilitated four focus groups with nurses, GPs and pharmacists in regional sites (n=13). Interviews and focus groups were transcribed and analysis thematically.

Needs Rounds was felt as an opportunity to enhance palliative care knowledge and practice in aged care. The educational aspect of Needs Rounds was highly acknowledged. However, sharing the learning with the broader team within the facility seemed to be more on an ad hoc basis.

Needs Rounds processes including resident identification, documentation and information sharing can be improved. An electronic system that is accessible to all staff is essential to document and share action plans and information with other staff.

Participants expressed their interest in continuing Needs Rounds beyond the life of the project. However, sustainability of medically-led Needs Rounds and GP engagement was a concern requiring long term commitment and appropriate incentive models.  

Institutionalising palliative care Needs Rounds in residential aged care contributes to improving workforce capability and palliative care practice. Characteristics of such a model depend on the context within which the model is implemented, organisational capacity, geography, and access to resources. The expansion of Needs Rounds as an effective and sustainable model requires further policy discussion at state and national levels.