Table 3 Proposed learning strategies to embed EOL care excellence

Coherence (what is the work)

• Support development of palliative care knowledge and skills

• Facilitate expert guidance for staff in situations of uncertainty e.g. feedback from palliative care on performance

• Regular education programs supporting the development of all acute care staff (including rotational and locum)

• Interprofessional team learning, in collaboration with palliative care team where real-life scenarios are explored

Cognitive participation (who does the work)

• Foster an interprofessional approach to EOL decision making and care provision through learning activities

• Define duties and responsibilities of health care staff

• Promote interprofessional working and learning

• Palliative care to provide guidance on interprofessional approaches to EOL care

• Develop and implement interprofessional learning activities to support EOL practices including practice-based or simulation activities

Collective action (how does the work get done)

• Review work structures, rostering and processes to support prioritisation of EOL care

• Educate staff on the long trajectory required for effective EOL care

• Create learning programs that challenge assumptions about roles and accepted ways of working

• Augment opportunities for co-working with palliative care team

• Simulated interprofessional learning experiences

• Prioritise dying patients on ward rounds

• Integrate EOL practices into outpatient setting e.g. have a checklist; review outpatient list who had multiple admission

• Interprofessional case-based discussions – range of contexts e.g. outpatients; acute setting

Reflexive monitoring (how is the work understood and changed)

• Support development of self-regulation on individual practices

• Enhance opportunities for audit and feedback

• Create opportunities for staff to debrief as a team

• Schedule regular ‘after death’ care reviews for multidisciplinary team with guidance from palliative care team