A survey of patients' experience of pain and other symptoms while receiving care from palliative care services.

Context: In Australia, patients at the end of life with complex symptoms and needs are often referred to palliative care services (PCSs), but little is known about the symptoms of patients receiving palliative care in different settings.

Objective: To explore patients' levels of pain and other symptoms while receiving care from PCSs.

Method: PCSs registered through Australia's national Palliative Care Outcomes Collaboration (PCOC) were invited to participate in a survey between 2008 and 2011.

Palliative Care Phase: inter-rater reliability and acceptability in a national study.

Background: The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding.

Aim: To test the reliability and acceptability of revised definitions of Palliative Care Phase.

Design: Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase.

Supporting service change in palliative care: a framework approach.

Background: Palliative care services are increasingly identifying areas for improvement, then trying to create appropriate changes in response. Nurses in particular are often expected to take leading roles in quality improvement (QI) but are not necessarily trained or supported in these processes.

Methods: A framework approach to change was developed to guide services through a change cycle and delivered via workshops by representatives of three Australian national projects.

Using palliative care assessment tools to influence and enhance clinical practice.

The Palliative Care Outcomes Collaboration focuses on supporting palliative care services in Australia to measure service- and patient-level outcomes, and to use these data to drive continuous quality improvement. The introduction of a suite of clinical assessment tools nationally has resulted in important enhancements to care provision at individual service level. Improved communication, enhanced assessment of patient needs, and improved identification of triggers for the need to change care plans or for referral have resulted from this change.