Supporting adoption of the Palliative Approach Toolkit in residential aged care: an exemplar of organisational facilitation for sustainable quality improvement.

National guidelines and resources to support a palliative approach in residential aged care were designed to improve provision of palliative and end-of-life care, however implementation has been sporadic. Objective To support implementation of a palliative approach in aged care using a facilitation training model and existing Palliative Approach Toolkit (PAT) resources. Methods Organisation-wide educational intervention delivered by a specialised Palliative Approach Facilitator for 6 months. Training included palliative approach principles, advance care planning, clinical management, equipment use, case conferencing, care planning and self-care. Results The intervention included 197 internal and external staff and reviewed advanced care plans for 484 clients. Increased staff knowledge and confidence with discussions involving advance care planning, end-of-life care and supporting bereaving families resulted. Conclusion This targeted intervention addressed barriers to adoption of a palliative approach, representing a flexible training model for building workforce capacity, promoting quality improvement and sustaining best practice in aged care settings. Impact statement: Palliative care provision in aged care is enabled by facilitation, adequate support for training, shared care-team expectations, and practice evaluation.