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This was an innovation project supported by the Better Care Victoria Innovation Fund.

Lead organisation

Palliative Care South East (PCSE)

Partners

  • Bolton Clarke
  • Monash University

Summary

PCSE provides home-based care to southeast Melbourne residents who have been diagnosed with a life-limiting illness and receives more than 500 referrals each year. 

In 2016–17, approximately 20 per cent of the 444 clients referred to PCSE had to be placed on the wait list and it became clear that these clients were deteriorating at a faster rate than they would have had they been able to access the service earlier.

PCSE established an early intervention palliative and supportive care clinic to provide these terminally ill but stable clients with access to support sooner, enhancing their quality of life.

Aims

  • Improve access to community palliative care services for terminally ill people who are early in their illness trajectory and whose condition is stable
  • Increase the number of stable clients accessing palliative care
  • Reduce the time between referral to PCSE and initial assessment
  • Reduce the number of clients on the wait list
  • Improve client decision making and care planning, including advance care planning
  • Decrease unplanned acute presentations
  • Increase the wellbeing of carers

Outcomes

  • Increased the number clients accessing the service while stable, with 94 per cent of clients accessing the services earlier
  • Decreased wait times from referral to initial visit from 52 days to 38 days
  • Reduced self-reported client presentations to the emergency department from 51 per cent to 19 per cent
  • Engaged 93 per cent of clients in advance care planning discussions, with 70 per cent having elements of a formal plan in place
  • Found that 65 per cent of deteriorating clients had stabilised six weeks after admission
  • Received positive consumer feedback, with 75 per cent of clients agreeing their quality of life had improved and 89 per cent of carers reporting that the support information provided was beneficial

Update

December 2020 – The Early Palliative Intervention Clinic (EPIC) has now been embedded into PCSE’s overarching model of care, establishing PCSE as the first community palliative care organisation in Victoria to offer an early intervention clinic. 

The initiative continues to deliver positive outcomes, and in 2020, the time from referral to assessment had reduced to the benchmark of seven days.

In addition, PCSE’s home care clients can now transition to EPIC if they are in a stable condition, enabling access to multidisciplinary care in a single visit.

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