Why do we need to be strategic about end of life care? Sue Hanson - - PowerPoint PPT Presentation

Why do we need to be strategic about end of life care?

Sue Hanson National Manager Palliative Care, LCMHC

• NOT Business or operational planning
• Address the biggest and most momentous decisions
• The kind that will affect the direction for service and

policy development for years to come

• May lead to substantially different organisational

structures for the provision of PEoLC

• May lead to major changes in the relationships between

key stakeholders

• ‘Strategic elephants’

What is ‘strategic’?

The difficulty lies not so much in developing new ideas as in escaping from the old ones.” John Maynard Keynes

Thinking strategically

Breaking the frames

By 2056 the Australian death rate will more than double to 320,0001 pa 51% of all deaths in those aged 80+2 400% increase in the number of people over 85 years ‘Tsunami’ of people with dementia 88% of those aged 65+ had three or more long term chronic illnesses 3 12% of the population aged >65 account for one third

• f admissions and half total bed days in acute care

The reasons why we need to think differently?

1:5 people whose death was expected were seen by a

SPCS1 (approx 20,000:145,000 per year)

85% English speaking2 2/3rds born in either Australia or England2 83% have a diagnosis of cancer 2 In 2009-10 245 Indigenous people seen by SPCS2 88% of residents left RAC due to death3

17% had stayed less than 3 months 19% between three months and one year

About 50% of all deaths occur in acute care settings

Looking at care at the end of life through different frames

National and State Key Strategic Directions

Improve appreciation of death

and dying as normal

Enhance awareness of benefits of

access to palliative care

Ensure appropriate and effective

palliative care is available to all based on need

Support collaborative, proactive

effective governance of national palliative care resources

Build and enhance the capacity of

all relevant sectors to provide quality palliative care

• Education and training for generalists
• Workforce development
• Establish state-wide clinical networks
• Explore new roles
• Implement standards, research, evidence

based practice

• Consistent approaches to admission

criteria, bereavement, care planning

• Improve data availability & quality
• Review funding
• Service planning
• Strengthen primary palliative care
• Implement RDF and strengthen SPCS
• Develop services – ATSI and CALD,

Bereavement , Pediatrics, SPCS Consult, Respite

• Strengthen capacity and capability in

RACF, community, acute care

National State & Territory

1.

Attempting to predict the future

2.

Reinforcing personal biases

3.

Seeing what you want to see

4.

Seeing what others want you to see

Barriers to effective strategic planning1

Attempting to predict the future

Reinforcing personal biases

Seeing what you want to see

Seeing what others want you to see

Think strategically Incremental planning not appropriate in times of reform Think differently More of the same will not be enough Put people at the centre It is what they need not what we do that should be central Know more about the needs and care of people as they approach the end of their life. Be inclusive of all people, regardless of their location or setting Organise for quality Focus on boundary issues, patient journey and continuity of care

Planning for the future

Winston Churchill once said: “If you don’t stand and fight when you have a chance to win, ONE DAY, you may be asked to go and fight when you have no chance”.

In conclusion?

Thank you