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Poi - Palliative Outcomes Initiative

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Description

Poi is a regional collaborative initiative of Auckland’s five specialist hospices, working together as an alliance:

These hospices are working closely with DHB teams, residential care providers (RCs), general practice teams (GPTs) and other stakeholders. 

Patients are identified in the community who are in the last 6-12 months of life and then strategies put in place to improve this time for them and their family.

The initiative centres around a Family / Whanau meeting, which then produces a Palliative Plan (PPA) for the lead clinician to implement, supported by the local hospice.

 Why Poi?

We know that:

  • Most palliative care deaths occur in a community setting – and these are increasing
  • There is inequality and unwanted variation in the quality and experience of support for those with primary palliative need
  • People are being identified as palliative too late in their journey
  • People are being referred to specialist palliative care too late
  • There is variable capacity and capability across the primary care and residential care sectors.

Auckland’s population is growing and aging which will impact on the demand for palliative care. Many people are being identified as having palliative care needs too late in their journey. As a result, they may have inappropriate treatment and may miss an opportunity for an improved quality of life during their final months.

Patients live in different settings and receive care from a variety of providers. There is the opportunity to support consistent responses to palliative care to optimise the experience of care for all patients and whānau regardless of setting. Auckland’s Specialist Hospices are keen to engage with community providers such as residential care and general practice to share resources, knowledge and provide as much mutual support to build their capacity to deliver a quality community-based palliative care response for Auckland’s diverse populations. This is a two way learning process, strengthening existing partnerships between hospices and other providers – a consultative, collaborative model and a team effort.

All healthcare providers have a collective responsibility to provide palliative care. Palliative care provision is complex, and a range of issues need to be addressed. Poi supports providers to build capacity and capability in their approach to palliative care.

What are the aims of Poi?

  • Improve primary care and residential care capability and capacity in working with palliative approaches to care
  • Improve identification and planning for palliative patients - better access, better patient experience and reduced variation in palliative care
  • Develop the community palliative care workforce
  • Strategic repositioning of hospices alongside community care partners.

 

 What does Poi do?

Poi will improve equity through people having better access to quality palliative services if they choose to die at home or in residential care. We have developed a regionally consistent approach for identifying palliative patients and developing a plan with, and for, them.

The participating hospices are providing general practice and residential care teams with supportive advice on the management of people with palliative needs and are helping GPTs and RCs to build their capacity and confidence in palliative care.

We are investing in the workforce, through developing General Practitioners with Special Interest (GPSIs) in palliative care, and a specialist nursing and psychosocial workforce.

Working together as a system, we will continuously improve services through regional coordination, transparency and data-driven learning.

The hospices will work closely with General Practice and Residential Care teams, DHBs and other stakeholders to support education and skills development and, where requested, provide input into high level care planning and support interventions.

Patients are identified in the community who are nearing the end of life and then strategies put in place to improve this time for them and their family.

The initiative centres around a Family / Whanau meeting, which then produces a plan for the lead clinician to implement, supported by the local hospice.

Referral Expectations

FOR THE USE OF GP/RC & HOSPICE ONLY - ONLINE FORMS

The Poi PPA form is now able to integrate with Medtech, My Practice and Evolution systems.  The installation link and guide can be found here 

For Residential Care and GP practices not using one of these systems, a new web portal has been developed to send PPAs and receive PAS responses.  If you have not yet received information with username and password, please send us a message via to be set up. 

Document Downloads

Contact Details

You can contact your local hospice working group member or chief executive.

Contacts for local hospice here.

This page was last updated at 12:40PM on October 14, 2019. This information is reviewed and edited by Poi - Palliative Outcomes Initiative.