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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

Emerging health and social policy considerations for safe and quality end-of-life care in Australia – the evidence, gaps and challenges

Deb Rawlings https://orcid.org/0000-0002-8998-9403 A * , Raechel Damarell https://orcid.org/0000-0002-6737-7537 A , Paul Tait https://orcid.org/0000-0003-4589-213X A , Amal Chakraborty https://orcid.org/0000-0003-1837-1224 A B , Angie Dalli https://orcid.org/0000-0003-1866-2670 C , Kim Devery https://orcid.org/0000-0002-8754-4785 A and Jennifer Tieman https://orcid.org/0000-0002-2611-1900 A
+ Author Affiliations
- Author Affiliations

A Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia.

B The University of Sydney, University Centre for Rual Health, 61 Uralba Street, PO Box 3074, Lismore, NSW 2480, Australia.

C Australian Commission on Safety and Quality in Health Care, Level 5, 255 Elizabeth Street, Sydney, NSW 2000, Australia.


Australian Health Review 47(5) 586-588 https://doi.org/10.1071/AH23166
Submitted: 20 July 2023  Accepted: 24 August 2023   Published: 12 September 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Recognition of the importance of end-of-life care will enable improvements in the quality of care delivered to patients and their families. Australia is experiencing an increasing number of deaths, (many expected), with an aging population who are living longer, often with multimorbidity. This makes end of life care a priority. The last year of someone’s life takes place in a complex healthcare system, with increasing pressures on care delivery, placing the spotlight on health service providers to ensure that teams and individuals are supported and enabled to provide such care. Two rapid literature reviews identified best practice principles and processes for delivering safe and high-quality end-of-life care in acute care, aged care and community settings. The reviews identified that end-of-life care is experienced within the whole health and social care system, including hospital admissions interspersed with care in the community, outpatient and emergency department visits and potentially admission to a hospice. Much of this last year of life is spent at home, which may be a personal residence, an aged care facility, prison, supported accommodation or even on the streets. Transitions across settings requires seamless care, as well as organisational readiness to deliver safe and culturally appropriate care. This is more important now with end-of-life care subject to quality assurance mechanisms within the National Safety and Quality Health Service Standards (2nd edn): Comprehensive care. This requires all sectors to work collaboratively when caring for someone at the end of their life in order to see positive changes in care outcomes.

Keywords: aged care, end-of-life, evidence base, health policy, literature reviews, palliative care, primary health care, quality and safety.

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