Pathway for Improving the Care of the Dying
The Pathway for Improving the Care of the Dying (PICD) was developed by the Southern Health Palliative Care Consultancy Service in 2007. The PICD is a modification of a number of end of life care pathways and retains the primary goal of all end of life pathways to optimise the care of dying patients and their families. Modifications of other international pathways were chosen to reflect the cultural issues within Australian society generally and, more specifically, differences in our health system and our own organisation. PICD has incorporated a risk screen tool to prompt social work involvement as the PICD developers felt this may act as a predictor of bereavement risk.
In developing the PICD, the Southern Health Palliative Care Consultancy Service sought to improve end of life care while optimising compliance in the acute care setting. The PICD documentation was designed to reinforce the philosophy that the terminal phase should be seen as a continuation of the multi-disciplinary approach, rather than a separate component of a patient’s care managed exclusively by a palliative care service.
The PICD was first introduced to Southern Health at the Clayton campus in 2007 as pilot project in General Medical wards. The General Medical units have the highest number of deaths, second only to the onsite inpatient palliative care units. It has since been implemented to include all wards of the Clayton Campus, the General Medical units at the Dandenong campus, and the Oncology unit at Moorabbin. Early discussions have commenced for the implementation in two Intensive Care Units and in the Emergency Department at Clayton.
As part of the introduction of PICD, a brochure was developed regarding specific issues that may arise when a person dies in the acute care setting. The brochure, Care of the dying patient and their family was adapted from the Palliative Care Victoria brochure and a PDF copy will be available soon.
The Palliative Care Consultancy Service at Southern Health has submitted the PICD to the Marie Curie Palliative Care Institute in Liverpool UK, for feedback and modification approval.
For further information regarding the PICD, please contact Christine Mooney, Palliative Care Nurse Consultant, Southern Health, or telephone +61 3 9594 6666.
