The acute health service’s policies make it clear that:
- the concerns of nurses and junior doctors are acknowledged and valued
- the judgement of nursing staff that a patient’s death is imminent is acknowledged and respected
- ensuring appropriate end of life care is as important as escalating care for a reversible condition
- a patient in physical, psychosocial or spiritual distress needs rapid assistance from a skilled clinician
- a second opinion from an independent senior clinician is to be sought if clarity is needed
- when managing conflict, complex family dynamics or ethical dilemmas, help can be sought from a person skilled in mediation, the rights of the person, bioethics or the law.
A process for escalating concerns is in place.
Reasons for referral to the palliative care consultancy service include:
- there are difficult symptoms
- discussions about goals of care, between team members or with patients and their families, are becoming complex
- bereavement risk is likely to be moderate or high.
All public metropolitan health services have a hospital-based palliative care consultancy service except for Royal Victorian Eye and Ear Hospital and Royal Women’s Hospital.
Each rural region has a palliative care consultancy service to provide specialist consultation to acute health services, among others.