Christy Hunt, Workforce Development Program Manager for the End of Life Directions for Aged Care (ELDAC) Program

Queensland University of Technology

Palliative care has been recognised by the World Health Organisation as a global health priority due to the rapidly ageing population and an increase of chronic illnesses around the world. It has also been noted as an area of high importance in the Royal Commission into Aged Care Quality and Safety. Consequently, a well-trained and prepared health workforce is required for the delivery of high-quality palliative care for people living with life-limiting illnesses.  End of Life Directions for Aged Care (ELDAC), funded by the Australian Government Department of Health and Aged Care, aims to improve the aged care workforce’s capacity to provide quality palliative and advance care planning for aged care recipients. Nationally there is not a consensus on capabilities for palliative care. With minimal inclusion of palliative care education in the vocational and tertiary curriculum, this work is vital to the improvement of care in the aged care sector. To this end, ELDAC’s workforce capability team are currently working on three key resources:

1. Online education directory: The PaCE Aged Care (Palliative Care Education Directory Aged Care) has been developed to link learning resources to palliative care capabilities for nurses, care workers and specialist palliative care professionals.  It also links aged care organisations and allied health professionals to resources within the ELDAC Care Model. Comprehensive resources can be sourced from all National Palliative Care Projects and the content is searchable with richly attributed tags and keywords that improve the accuracy of your search result. This education directory is now available on the ELDAC website.

2. Learning pathways: Current assessment and mapping of educational resources against regulatory frameworks have indicated a need for targeted orientation resources to upskill staff entering aged care facilities. Due to extreme workforce shortages, staff are often employed without the requirement of knowledge and skills in contemporary palliative care practices.  Workforce development was also a key finding within the Royal Commission into Aged Care Quality and Safety. Two new learning pathways, the ‘Nurse into Palliative Care’ pathway and the ‘Aged Care Worker’ learning pathway, will focus on the immediate knowledge and skills required to begin work in the aged care setting.  Additional learning pathways will be developed during 2023 which will include more advanced and technical skillsets.

3. Capabilities: New workforce capabilities are currently being identified through a modified Delphi research study. The capabilities will be informed through consumers of palliative care services and palliative care clinical experts. These capabilities will be underpinned by the Palliative Care Standards and will include resources specific to meet the new Aged Care Quality Standards (due for release in 2023).  A consensus-based, multi-professional, capability framework for the provision of palliative care across settings is needed to assist aged care providers to develop the workforce capability in delivering best practice palliative care. Such a framework will guide entry-to-practice education in the vocational education and training sector, higher education settings, and within workplace-designed education to ensure that the future and current workforce are adequately prepared to provide palliative care irrespective of place of practice.

The ELDAC website (www.eldac.com.au) contains home care and residential aged care toolkits, which include links to education and learning opportunities, to support all levels of clinical staff. For more information on these projects or to provide any feedback, please contact the ELDAC Workforce Development Manager, Christy Hunt by email christy.hunt@qut.edu.au

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.

Rosemary Fisher*, Antony Linden*, Tanya Linden**, Kim T.C Le*

*Swinburne University of Technology; **The University of Melbourne

Quality of life for the elderly is a global concern. Unfortunately, the most vulnerable group of our population was at the centre of media campaigns, and government and community concerns due to the substandard care they were experiencing. In response to these concerns, in 2020 aged care nurses and consultants Christine Brodrick and Diana Cooper developed Tell Touch, a digital application designed to address problems with the quality of care provided to residents of aged care homes (ACHs). Tell Touch enables aged care service providers to ensure their complaints and feedback processes comply with or exceed the Aged Care Quality and Safety Commission (ACQSC) Standard 6. The app uses principles of cultural inclusion, accountability, accessibility, and streamlined feedback to collect feedback and complaints from residents of ACHs and their family members or carers. It also produces reports that identify opportunities for improvement in the quality of care provided to residents.

An independent pilot evaluation of the app was conducted in ten ACHs to assess its effectiveness. The project contextualised the well-accepted Technology Adoption Model adopted by Holden et al [1], to explore the user’s experience of implementing Tell Touch in ACHs by examining perceptions of ease of use, usefulness, social influence to use, training received, technical support provided, perceived usefulness for consumer care, social influence of consumer’s family to use, and demographic variables.

The results of the evaluation were positive, with mean results above the midpoint on all questions. Perceived ease of use, satisfaction with the app, social influence to use the app, complete use of app functions, and intention to utilise the app were all above five on a 7-point scale. Thematic analysis of interviewee data provided additional insights into why and how staff perceived using Tell Touch to be satisfactory. In addition, it captured some suggestions for potential improvements to the app.

Overall, the evaluation concluded that Tell Touch is an effective information technology (IT) communication platform for complaints and feedback handling in ACHs. This suggests the app's guiding principles were meaningful to users and successfully implemented. Furthermore, the evaluation supports suggestions that utilising real-time data gathered from feedback apps could contribute to transforming the aged care service delivery model, making it more accountable, consumer-centred, and compliant with government legislation. 

Lessons learned from the implementation and use of Tell Touch include:

1. Users cannot be assumed to all have the same level of IT literacy skills
2. A ‘go to’ person is needed in each organisation to train new users
3. Clients need to be regularly followed up after onboarding to ensure they are using and are aware of all features.

This pilot evaluation highlights the potential for technology to improve the quality of care provided to elderly residents of ACHs. The use of Tell Touch has enabled these ACHs to streamline their complaints and feedback processes. This has enabled the identification of opportunities for improvement in the quality of care provided to residents. By collecting real-time data, ACHs can become more accountable, and consumer-centred as well as compliant with government regulations, whilst ensuring the highest quality of care is delivered for their residents.

The successful implementation of Tell Touch demonstrates the potential for technology to transform the aged care service delivery model. By prioritising cultural inclusion, accountability, accessibility, and streamlined feedback, technology can support the provision of high-quality care to elderly residents of ACHs. As the global population ages, it is essential that we continue to develop and implement innovative solutions to improve the quality of life for the elderly. Tell Touch is a promising solution that can help achieve this goal.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.