CareSearch, NSAP and PCOC work together to improve palliative care quality in Australia through several initiatives: 1. NSAP uses standards self-assessments to help services develop quality improvement plans, while PCOC measures outcomes to benchmark performance. CareSearch provides the latest evidence. 2. They signed an agreement in 2010 to better integrate activities using a common framework to guide quality improvement. 3. Workshops teach the Working Together Change Framework to help services identify issues, causes, evidence-based solutions, develop plans, implement changes, and review results. Evaluations assess the workshops' effectiveness.

1. CareSearch, NSAP and PCOC
Evidence, standards and quality, but
what does it actually mean?
Tieman JJ, Rawlings D, Mills S, Banfield M
PCNA Conference, December 2012

2. Overview of session
•Quality Issues: Drivers, evidence, approaches
•Working Together: CareSearch, NSAP, PCOC
•Six Questions

3. Drivers for change
•Health care variability
• Not receiving recommended care
• Fragmented care
•Demand issues
• Increased demand
• Changing patterns of need
•Dynamic evidence base
•Costs and resources
•Health information technology

4. QI and Evidence
•EBM/EBP: Evidence to inform quality care
•Evidence as content in QI processes
•Value add between EBM and QI
•Emerging evidence of value of QI
•QI processes as a source of new evidence

5. Working Together Partnership
•CareSearch, NSAP, PCOC
•MOU signed in 2010
…common interest, informed by
different but aligned perspectives,
in improving palliative care in Australia
by upskilling palliative care services,
facilitating quality improvement and
encouraging the use of evidence in practice.

6. Working Together: NSAP, PCOC, CareSearch
All programs funded by Department of Health and Aging
All work with Palliative Care Services to improve Service quality
STANDARDS
NSAP: National Standards Assessment Program
• Services complete a self assessment snapshot
every 2 years against the standards
• Create and implement a quality improvement
action plan, based on these results

7. OUTCOMES
PCOC: Palliative Care Outcomes Collaborative
Utilises standardised validated clinical assessment
tools to benchmark and measure outcomes in
palliative care
EVIDENCE
CareSearch:
Australia’s Palliative Care knowledge base
Latest resources and evidence

8. Working Together Projects
•Integration of current activities
•Identification of services
•Working Together Change Framework
• WTCF Workshops
• WTCF Study
•Change Management Hub:
• Tools registry
• QI searches

9. How do we work together?
Evidence Sources for NSAP Self Assessment
PCOC: Palliative Care Outcomes Collaboration
Outcomes can be used as an evidence source for your
NSAP Self Assessment
CareSearch
Provides links to quality tools which can be used for
NSAP Self Assessment
Quality Improvement Results and latest evidence for
development of a Quality Improvement Action Plan
PCOC Report
NSAP Results & Key Improvement Areas
CareSearch Evidence
PCOC CareSearch
NSAP
PCOC NSAP CareSearch
Quality
Improvement
Action Plan

10. Working Together Change Framework

11. Question 1:
•Think about how you know there is a
problem. Describe the problem for others.
Be specific about the problem.
•Outline how big a problem it is and how
it affects your work and your patients.
•You also need to consider whether it is a
problem that you can solve.
Is there a
problem?

12. Question 2:
•Do some analysis on possible causes
• Service characteristics
• Patient population
• Feedback from patients/staff
•Check to see if there are reports or articles
on similar problems
•Speak with other services about whether similar issues
What is
causing the
problem?

13. Question 3:
•Check for evidence on the specific issue.
Find out if there is evidence for new or
different approaches.
•Find out if there are tools or measures you
could use.
•Review what is effective in change management.
Think if some of these strategies could be used in your plan.
Is there
evidence
about what to
do?

14. Question 4:
•Check your plan indicates
• Who
• What
• By when
•Make sure your plan is suitable for your service.
•Identify and include measures that can be used
to show if things are changing
Does your
plan address
the issues?

15. Question 5:
•Monitor what is happening as you
implement the plan.
•You may need to vary your plan. Things change.
People change. New information may emerge.
•Keep a note of why something changed and
what you did in response.
Were you
able to
implement
your plan?

16. Question 6:
•Review everything that happened.
Just because you did something
does not mean that what you wanted to,
or expected to, happen actually did happen.
•Determine if the problem has been solved.
Think about whether a different approach is needed.
Have you
reviewed
what you
did?

17. WTCF Workshop Evaluation
•Ethics received for evaluation study
• Post-workshop questionnaire
• Follow up survey (8 weeks)
•Objectives
• To determine Workshop participants’ responses to the
Working Together Change Framework
• To evaluate the effectiveness of the Workshop content and
format
• To determine if participation in the Workshop led to
change activity in the service

18. • Services can identify quality improvement
opportunities through PCOC, NSAP processes
• Evidence summaries on priority areas available
through CareSearch
• Workshops and projects to build knowledge and
expertise in QI

19. CareSearch, NSAP and PCOC are funded by the Australian
Government Department of Health and Ageing.