Evaluating the impact of national education in pediatric palliative care: the Quality of Care Collaborative Australia

Abstract

Purpose

The Quality of Care Collaborative Australia (QuoCCA) provided pediatric palliative care education across Australia with the aim of improving the quality of services. The education was delivered through a collaboration of six tertiary pediatric palliative care services, through funding for Nurse Educators, Medical Fellows, a National Allied Health Educator, and national project staff.

Methods

Pre- and post-education surveys were completed by participants immediately following the education, and confidence and knowledge were measured along nine domains related to the care of the child and family, including managing a new referral, symptom management, medications, preparing the family, and using local agencies.

Results

Education was provided to over 5,500 health and human service professionals in 337 education sessions across Australia between May 2015 and June 2017. Paired pre- and post-surveys were completed by 969 participants and showed a significant improvement in all the domains measured. Those with no experience in caring for children receiving palliative care showed greater improvement following QuoCCA education compared to those with experience, although the latter had higher scores both before and after education. Similarly, those with no previous education showed greater improvement, but those with previous education showed higher scores overall. Participants in full-day and half-day sessions showed greater improvement than those in short day sessions. Thus, the dosage of education in the length of the sessions and prior attendance impacted knowledge and confidence. Topics requested by the participants were analyzed. Educator learnings were that education was more effective when tailored to the needs of the audience, was interactive, and included story-telling, case studies, and parent experiences.

Conclusion

These results encouraged the continuation of the provision of education to novice and experienced professionals who care for children with a life-limiting condition, leading to higher levels of confidence and knowledge. The learnings from this evaluation will be transferred into the second round of funding for the national QuoCCA education project. The next stage will focus on developing simulation and interactive training, accessible training modules, and videos on a national website.

Keywords:

• training
• evaluation
• health care
• education dosage
• confidence

Supplementary materials

Pre- and post-education survey content

Demographic information collected in the pre-education survey included

• Participant – name, organization, postcode, and occupational group.

• Experience – percentage of week involved providing palliative care directly to patients/families, number of children cared for in the past year who have died, and previous involvement in the care of a child with a life-limiting condition.

• Previous education – previous education days attended led by the Pediatric Palliative Care Service in that state.

Education assessment

• While preparing for this education session, do you feel that you are confident in managing the new referral of a child with palliative care needs to your service?

• While preparing for this education session, do you feel that you are confident in the management of symptoms that a child with a serious life-limiting condition may experience? – pain, nausea, dyspnea, seizures, fear or anxiety

• While preparing for this education session, how confident do you feel in helping a family prepare for the death of their child?

• While preparing for this education session how confident do you feel giving medications, including setting up a subcutaneous delivery system?

• While preparing for this education session do you feel that you have knowledge of resources such as agencies that can assist you in providing palliative care in your area?

The post-education survey repeated these questions preceded by the phrase “since attending the education session” or “after completing the education session…”.

Education topics

The pre- and post-survey forms included open text responses about the topics that participants hoped to hear and topics that they would like to be covered in the future. The questions were as follows.

• Pre-survey – are there any other topics you would like to see covered in this session?

• Post-survey – are there any other topics which you would like to see covered in sessions in the future?

Acknowledgments

This project involved a collaboration of six tertiary pediatric palliative care entities throughout Australia managed through the National Project Lead Entity, Children’s Health Queensland (CHQ) Hospital and Health Service, headed by the National Project Sponsor, Chief Executive CHQ, Fionnagh Dougan. The collaboration included staff from tertiary Pediatric Palliative Care Services from Queensland Children’s Hospital, Brisbane, Sydney Children’s Hospital, Rand-wick, John Hunter Children’s Hospital, Newcastle, Royal Children’s Hospital, Melbourne, Women’s and Children’s Health Network, Adelaide, and Perth Children’s Hospital, Perth. Appreciation goes to the collaboration members and their supporting agencies, including the Project Leads from each state – Sara Fleming, South Australia, Jenny Hynson, Victoria, Marianne Phillips, Western Australia, Suzanne Momber, Western Australia, Sharon Ryan, NSW, and Susan Trethewie, NSW. Anne Bernard, senior biostatistician from QFAB Bioinformatics, provided excellent guidance in the development of the statistical analyses. Many thanks also to the participants in the QuoCCA education from both the private and public sectors and their helpful assistance in completing the evaluation tools. The QuoCCA Project was undertaken through Australian Government Department of Health funding provided from the National Palliative Care Projects operating under the Chronic Disease Prevention and Service Improvement Fund, grant funding round H1314G012.

Disclosure

The authors report no conflicts of interest in this work.