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Oceanic Palliative Care Conference 2021
Oceanic Palliative Care Conference 2021
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10 September 2021
9:45 am - 10:00 am - 10 September 2021

21OPCC - Day Four

Room 1
Master of Ceremonies - Di Darmody

Welcome and conference overview

Acknowledgement of Country
10 September 2021
The recipient of the Ian Maddocks Guest Lecture is considered to be the best submission by an author under the age of 40 who is engaged in the study or delivery of palliative care in any of its component disciplines.

Dr Hsien Seow, Canada
Canada Research Chair in Palliative Care and Health System Innovation and an Associate Professor in the Department of Oncology, McMaster University in Ontario, Canada

Background 
Health care providers know that integrating an early palliative care approach is difficult, in part because palliative care is associated with death and dying. As a result, palliative care is more commonly delivered at end of life or the “11th hour” as opposed to earlier in the disease trajectory. Many patients and families facing a serious illness describe feeling overwhelmed and unaware of what to expect. They often say, “I wish I had known that sooner.” How can we change this common experience?
 
Aim (or goal of work)
·        To find ways to position palliative care approaches upstream in the illness trajectory that are acceptable to patients and families. 
·        To understand how people can move from being passive to active in their illness journey. 
·        To determine what are the keys to those who have an ‘in the know’ experience vs. ‘in the dark’.
 
Methods (including design, method or approach taken, setting, data collection, and analysis/evaluation approach as applicable) 
We interviewed patients & families about their understanding of their illness and its progression. They have shared the most intimate details and frustrations of facing serious illness and the health system. We also went through the stories of the ‘thousands of patients’ we served at the bedside near and throughout end-of-life. We reflected on the differences between those who felt “in the dark” and lost versus those who felt “in the know” and in control about their illness journey. We synthesized all these lived experiences to uncover the keys to feeling more hopeful and prepared when facing serious illness. 
 
Results / Findings (conclusions, lessons learnt)
The result is the Waiting Room Revolution (WRR), a solution to help people feel more in control, confident, and prepared throughout their illness journey. We uncovered 7 keys to empower people to plan ahead, have more choices, and customize their care plan to their wishes and preferences. These keys are simple to understand, easy to implement, and applicable at any stage in the illness journey. We have presented the keys as a podcast by the same name. In this session, we will describe the 7 keys that can lead to an ‘in the know’ experience. 
 
Conclusion 
We have come up with language and metaphors that are acceptable to patients and families, that can support an earlier palliative care approach—that they can initiate. This will ultimately result in a better experience.
10 September 2021
10:45 am - 10:50 am - 10 September 2021

Comfort Break

10 September 2021
Chris Schilling, Director, Economics, KPMG Australia 

KPMG’s Investing to Save – Palliative Care report highlighted the strong return on investment that Australia’s world class palliative care sector delivers. But what else is needed to secure increased funding of palliative care? Where do information gaps challenge the sector and hold us back from more informed decision-making? What change is required to help us meet our vision for the future? This session will highlight the good news story of the initial Investing to Save analysis; present some challenges identified in our new report: Information gaps in Australia’s palliative care; and provide a Q+A forum for getting your views and input to help advocate for change.
Department of Health proudly supporting this discussion on: Palliative Care is Core Business in Aged Care

The session aims to discuss how to meet the growing palliative care demands of Australia’s ageing population by ensuring that palliative care is recognised as core business in aged care, how to best meet the findings of the Royal Commission into Aged Care Quality and Safety and ensure that aged care providers and staff are supported through appropriate systems, funding and training. 

Invited Guest Speaker;

  • Josh Cohen (Chair): Palliative Care Nurse Practitioner, Calvary Health Care Kogarah
  • Professor Melanie Lovell: Senior Academic, Centre for Learning & Research in Palliative Care, Hammond Care
  • Professor Deborah Parker: Professor of Aged Care & Dementia Nursing, University of Technology Sydney / Cheif Investigator, ELDAC
  • Peter Jenkin: Palliative Care Nurse Practitioner, Resthaven
  • Patricia Sparrow: Chief Executive Officer, Aged & Community Services Australia
  • Prof Liz Reymond: Director, Brisbane South Palliative Care Collaborative (BSPCC) 
Clinical Research Manager
Fisher & Paykel Healthcare 


Regardless of aetiology, dyspnoea is one of the most common symptoms reported by patients with advanced disease who are nearing the end of life. Because of the complex ventilatory, biochemical and psychological causes, dyspnoea presents a challenging symptom to manage in this group of patients. Dyspnoea or breathlessness is largely a subjective symptom and difficult to quantify, but despite this, the symptom can be overwhelming for patients. It may range from feeling uncomfortable and aware of their breathing, associated with physical exertion, or through to a highly anxious and fearful experience at rest. This may be further exacerbated as breathless patients withdraw from family and friends by limiting conversations, activities and social interactions as a result of their continual fight to breathe. 
 
Initial management of dyspnoea seeks to concurrently address the symptom while identifying and treating any underlying causes. When, however, these causes are no longer reversible, symptom relief becomes the main objective of care. Treatment can be balanced between pharmacological and non-pharmacological interventions with a focus on individual patient centric and holistic care paradigm with dyspnoea management a central part of the of the care matrix. 
 
One potential non-pharmacologic strategy that may improve patient comfort and relieve symptoms associated with breathlessness is nasal high flow therapy (NHF). NHF provides heated and humidified gas/air ± oxygen which acts to improve secretion clearance and reduce metabolic workload. In patients with respiratory distress and failure, NHF has demonstrated reductions in patient’s work of breathing, respiratory rate while improving tolerance and comfort. The mechanisms of actions may also provide similar symptom relief in palliative care enhancing quality of life, decreasing symptom burden, increasing patient alertness and enriched patient and family interactions during end of life care processes. This presentation seeks to outline the potential benefit of NHF maximising comfort for various stages of the palliative care timeline.

10 September 2021
11:35 am - 12:05 pm - 10 September 2021

Break - Poster Tour and Exhibition Zone

10 September 2021

Jenny Hynson
Paediatric Palliative Care Australia and New Zealand

Background
One of the characteristic features of children’s palliative care is prognostic uncertainty. Many of the illnesses encountered progress in ways that can be difficult to predict and while welcome, therapeutic innovations add further to the uncertainty. Even the most experienced clinicians struggle to know if and when any given child’s condition might deteriorate. This makes decision-making challenging. When should this child be referred to a specialist palliative care service? What interventions are and are not in their best interest? The answers to these questions may be viewed differently by different clinicians depending on their values, experience and belief systems. Added to this are the emotional responses that clinicians can experience. Grief, guilt and a desire to ‘fix’ problems can all influence how clinicians think and act.
Providing palliative care to children with life-limiting conditions requires sophisticated team work both within the specialist palliative care team itself and between the multitude of teams often involved. The diagnostic diversity encountered in this area means that specialist paediatric palliative care providers must work with multidisciplinary teams from a range of paediatric specialties such as neurology, oncology, neonatology and cardiology. There is the added complexity of working with clinicians from community palliative care, disability, education and general practice. All of these teams will have their own value systems, world views and philosophies of practice.
All of these factors create an environment in which conflict can arise. In turn, conflict can impact negatively on patient care and lead to moral distress and burnout for clinicians.
This workshop will explore what drives conflict between individual health professionals and teams and offers participants an opportunity to learn new skills in working through ethical dilemmas, moral distress and conflict.
While the workshop will explore intra- and inter-team conflict in the paediatric setting, the strategies discussed will have broader application across palliative care.

Aims and Objectives
  • To better understand the drivers of conflict between health professionals and teams
  • To examine some of the more commonly encountered ethical dilemmas and potential approaches to thinking these through
  • To better understand the origins and manifestations of moral distress
  • To explore strategies for resolving conflict  Key Learnings
  • Recognition of the factors that drive conflict
  • Approaches to ethical dilemmas
  • Approaches to managing moral distress
  • Basic skills in mediating disputes between individuals and teams 
10 September 2021
2:00 pm - 2:15 pm - 10 September 2021

Comfort Break

10 September 2021
10 September 2021
3:50 pm - 4:00 pm - 10 September 2021

Comfort Break

10 September 2021
Distinguished Professor Patsy Yates AM

Distinguished Professor Patsy Yates, AM, PhD, RN, FACN, FAAN is the Executive Dean of the Faculty of Health, Queensland University of Technology (QUT).  Patsy is a Registered Nurse with extensive experience as a leader in education and research in the health sector. Prior to her appointment as Executive Dean in 2020, Patsy was Professor and Head of the School of Nursing at QUT.
Patsy is also a Co-Director for QUT’s Centre for Healthcare Transformation. She leads a large competitively-funded research program focused on developing workforce capacity in cancer, palliative and aged care, advancing the management of cancer-related symptoms and treatment side effects, and strengthening the nexus between research, policy and practice in cancer,  palliative and aged care.
She holds visiting appointments as Lead Researcher for the Cancer Nursing Professorial Precinct at Royal Brisbane and Women’s Hospital, Director for Queensland Health’s statewide Centre for Palliative Care Research and Education, and Visiting Fellow at Princess Alexandra Hospital. She is also a Senior Fellow of the Centre for Health Outcomes and Policy Research, University of Pennsylvania.
Patsy is a Fellow of the American Academy of Nursing and the Australian College of Nursing.  She has been inducted into the International Nurse Researcher Hall of Fame of Sigma Theta Tau International Honour Society of Nursing and was awarded the prestigious USA Oncology Nursing Society Distinguished Researcher Award in 2018.  She has also received a Citation from the Australian Learning and Teaching Council for Outstanding Contribution to Student Learning.
Patsy is the current President of the International Society of Nurses in Cancer Care and a past-President of Palliative Care Australia.
10 September 2021
5:00 pm - 5:15 pm - 10 September 2021

Closing Choir Performance

Room 1
The Virtual Conference Choir will perform - stay tuned to find out how you can get involved.

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