Ms. Esther McMillan-Drendel1, Mr. David Marco2,3, Professor Brian Le1,3, Professor Jennifer Philip1,2,3
1 The Royal Melbourne Hospital, Parkville, Australia, 2 St Vincent’s Hospital Melbourne, Fitzroy, Australia, 3 University of Melbourne, Parkville, Australia
Biography:
Esther is a Registered Nurse with extensive experience in senior positions across Australia in palliative care, intensive care, medicolegal and forensic medicine.
Establishing an Australian first, the Victorian Palliative Care Advice Service enables the public and clinicians to access specialist palliative care advice and support when they need it most.
Abstract:
Background: Ongoing challenges exist in developing sustainable service models to meet the increasing palliative care needs of patients at home. The Palliative Care Advice Service (PCAS) was established in 2020 to provide free and accessible state-wide telephone-based specialist palliative care support and advice for healthcare professionals and the public in Victoria. Calls from paramedics have increased to the service as families with palliative care needs turn to 000 in times of crisis.
Aims: Investigate the context and content of calls from paramedics to PCAS in 2023, including emergency department diversion rate and providing support to the community and paramedics in palliative care situations.
Methods: Specialist Nurse telephone operators captured outcome measures relating to caller demographics, disease type, reason for call, and perceived utility of service. This study is a retrospective analysis of calls from paramedics in 2023 made to PCAS.
Results: Calls from paramedics to PCAS climbed from 1 in 8 to 1 in 4 calls in 2023. Most patients seen by paramedics were classified as unstable (56%) and in need of symptom management (46%) and medication advice (45%). 25% of calls from paramedics were escalated to a palliative care consultant for specialist support. These values were higher for calls originating from regional areas. Paramedics demonstrated support for the PCAS service and reported their issue was “Very Much” or “Completely” addressed in >70% of calls. 37% of calls from paramedics were believed to avoid an emergency department presentation.
Conclusions: PCAS was shown to be an integral and useful resource to support paramedics in the field. The service provided a high impact, low-cost solution without requiring complex technology, delivering a rapid connection for the community and clinicians with specialist palliative care expertise that might otherwise be unavailable, particularly in regional areas.