Hospitals are where 54% of Australians will die, yet many hospital staff admit they are ill-equipped to best comfort patients approaching end of life and their families.
Dr Caroline Phelan leads a team at Flinders’ Research Centre for Palliative Care, Death and Dying that is evaluating End-Of-Life Essentials education and improving training resources for people who work in acute hospitals.
“Health care professionals need to improve the level of quality end-of-life care being delivered in hospitals, and we have been able to successfully help with this through providing the effective End-of-Life Essentials education modules,” says Dr Phelan.
The End-of-Life Essentials Project (EOLE) has received Federal funding, under the National Palliative Care Projects, since 2015, to enhance the quality of end-of-life care service delivery and increase acute hospital clinician awareness of the needs of people who are dying, their families and carers.
The EOLE primary areas of focus include building confidence and strategies to have end-of life care conversations, compassion in the emergency department, managing differences of opinion among staff about patient care management, and – most importantly – showing empathy in conversations about patients’ future goals of care.
“The compassionate preparation of bodies and minds for death requires a well-informed and considered mind shift,” explains Dr Phelan. “The EOLE project has been able to educate and remind clinicians about what is important for individuals who face the end of life.”
The EOLE Project offers free peer-reviewed online education and training resources on health care at the end of life in acute hospitals for nursing, medical and allied health professionals.
EOLE education modules are based on the content of the National Consensus Statement: Essentials for safe and high-quality end-of-life care and the NSQHS Standards.
This training system is now being imbedded into hospital intranet services around the country, and more state health organisations are supporting the training module.
“Hospitals are the places where most Australians die, and hospitals have been identified as providing care that is not always appropriate,” says Dr Phelan. “Therefore, it has been critical for EOLE education resources to be easily and effectively used by doctors, nurses and allied health professionals who work in acute hospitals.”
So far, more than 43,000 learners have registered for EOLE education, who have completed more than 110,700 training modules. The resources are also having ongoing influence, with more than 17,100 Training Resources downloaded and more than 36,300 ‘My Toolkits’ downloaded to support further education
EOLE has received endorsement across State Health Departments in the ACT, Queensland Victoria, New South Wales, and the South Australian Palliative Care Statewide Clinical Network. EOLE education will also be embedded within the health service education program and learning management system for Tasmania Health, Calvary Health (Australia wide), Monash Health and the ACT Ambulance Service.
With funding guaranteed until mid-2026, Dr Phelan is already delighted that these figures show that EOLE is growing in both its reach and impact.
“Clinical staff are reporting back to us that EOLE has changed their clinical practice behaviour, saying to us they are more confident and comfortable talking with patients and relatives about important but serious discussions about end-of-life care,” she says.
“One EOLE training recipient told me they are no longer afraid of having the big conversations about death – and that as a result they now have greatly increased confidence in the care they are delivering, and are so proud of being able to deliver better quality end-of-life care.”
Dr Phelan believes the critical factor behind this success has been the convenience and efficiency of online delivery.
“The hospital system is under enormous budget, staffing and resource pressure, so face-to-face training suffers in hospitals – but EOLE has succeeded because it has elevated online learning that is efficient and engaging.”
The easy access to the EOLE educational resources has also been enthusiastically embraced by medical professionals outside of the hospital system, including General Practitioners, Medical Centre staff and private practitioners.
“It has been embraced by everyone because it’s free and its easily accessible. We have broken it down into 30-minute modules, so staff can engage with this when they have time available – and undertaking the course and learning is manageable for them.”
Dr Phelan is especially proud that the resonance and success of the EOLE education program shines a light on Flinders University for the excellence of how it delivers palliative and end-of-life care research and education.
“Through our research we know that our project is increasing knowledge, skills and confidence of hospital clinicians in end-of-life care,” she says.
“Death is an important part of the work that hospitals do, so it is crucially important that they provide the opportunity for more people to die with dignity.”