Advance Project boosts confidence for sensitive conversations about end of life

Family doctors and their teams report being more likely to initiate discussion about advance care plans and palliative care with patients after taking part in The Advance Project training and using its resources.

Professor Josephine Clayton in discussion with The Advance Project teamNew research published in British Medical Journal Open highlighting the value of the Advance Project was based on interviews with staff from 18 general practices and four primary health networks after completing the national training program.

Those interviewed “generally agreed” that The Advance Project training and resources led to changes in their own behaviour and increased their awareness of the importance of advance care planning and palliative care discussion with their patients.

As HammondCare marks National Palliative Care Week, the essential role of advance care planning in enabling better quality end of life care is an important discussion.

The Advance Project, led by HammondCare, promotes a team-based and systematic approach for initiating advance care planning and palliative care needs assessments in general practices.

The research, Australian general practice experiences of implementing a structured approach to initiating advance care planning and palliative care: a qualitative study, has been published as HammondCare prepares to roll out training and resources for the latest phase of the Advance Project focussed on supporting people living with dementia nearing end of life.

Project lead Professor Josephine Clayton said the qualitative research findings suggest that the team-based Advance Project approach can make it easier for general practices to get involved in advance care planning and palliative care needs assessment. “Australia’s ageing population and growing prevalence of chronic and complex health conditions make primary care settings the ideal place to initiate conversations about the planning for end of life,” Prof Clayton said.

She said the 13 GPs, 13 general practice nurses, 9 practice managers, 3 allied health staff and 7 primary health network staff interviewed reported benefits for patients including increased awareness of advance care planning, engagement with families/carers and “peace of mind”.

The ability of the practice to make the best use of support available through their local Primary Health Network both before and during implementation was a key factor in resources being integrated into routine practice.

Prof Clayton was the senior author on the paper that was published by a team including first author Srivalli Vilapakkam Nagarajan, and co-authors Virginia Lewis, Elizabeth J Halcomb, Joel Rhee, and Jennifer Tieman.

This latest research evaluates the second phase of the Advance Project looking at how it can assist GPs, nurses and practice managers with advance care planning and palliative care discussions.

The third phase to be rolled out soon involves tailored resources, online and train the trainer courses for initiating advance care planning and palliative care needs assessment with people living with dementia. The training is intended for frontline aged and primary care staff.

HammondCare is working on the third phase with Caresearch, Flinders University.

In the earlier first phase of the project, general practice nurses from across Australia took part in a mixed-methods evaluation.

Find out more about The Advance Project