Hospice New Zealand

Fundamentals of Palliative Care

Updated October 2014

The Fundamentals was published in October 2011, followed by trainer training throughout the country, for palliative care and gerontology professionals. In 2012, the first year of the Fundamentals being delivered, there were 7,141 deliveries to individuals attending one of the learning packages, increasing to 10,384 deliveries in 2013.

Fundamentals review
Earlier in 2014, the Hospice NZ board of trustees agreed to a review and rewrite of the HNZ Fundamentals of Palliative Care (the Fundamentals) education programme so that it will be suitable to be used in all palliative care provider settings. The current resource is aimed at aged care but this is to be broadened to include home, hospital, primary care and Maori health providers.

Hospice NZ is using a formal project governance approach to this initiative, which includes a governance and a working group. The education Project Governance Group represents and has experience of most of the settings where patients, families and whānau receive palliative care. Michal was on the original Hospice NZ Education Governance Group formed back in 2010 to advise the development of the aged care focused Fundamentals of Palliative Care programme and will be invaluable in ensuring the early principles of the programme are translated into the generic version of the Fundamentals.

The members are:
Mary Schumacher – CEO, Hospice New Zealand and chair of the governance group
Dr Michal Boyd RN, NP, ND – Sr Lecturer, Freemasons' Dept. of Geriatric Medicine University of Auckland and Gerontology Nurse Practitioner Community Services for Older Adults, Waitemata DHB
Julie Haggie – CEO, Home and Community Health Association New Zealand
Dr Marion Taylor – GP, Wicksteed House Medical Centre Wanganui and Senior Medical Officer, Hospice Wanganui
Kate Gibb – Nursing Director, Older people – Population Health at Canterbury DHB
Dr Brian Ensor – Director of Palliative Care, Mary Potter Hospice and Clinical Advisor to the Hospice NZ board of trustees

Working alongside the Hospice NZ Practice Advisor, Anne Morgan are the education Project Working Group. The members of this group represent all the settings the reviewed resource will be offered.

The group members are:
Rachel Hale -  Matamata Medial Centre, Nurse Practitioner Older Person
Liz Angus - Access Homehealth Limited, Community Team Leader
Gayle Elliott - Southern DHB, Clinical Nurse Specialist Hospital Palliative Care Service (to be confirmed by HPCNZ)
Trish Fleming - Hospice West Auckland, Learning and Development Manager
Jenny Blyde - Hospice Taranaki, Counselling and Bereavement Service Team Leader
Jan Waldock - Arohanui Hospice, Lead Clinical Nurse Educator
Chris Murphy - Mary Potter Hospice, Community Liaison – Palliative Services
Dr Oleg Kiriaev - Mental Health Service Older People CMDHB and Totara Hospice South Auckland, Geriatrician and Palliative Care Consultant
Sylvia Meijer - Nurse Practitioner Older Adult, Team Leader Health of Older People Team, Central PHO, Horowhenua (new to the group, joining the project charged with ensuring that the resource remains ‘fit for purpose’ for the aged care setting)
Anne Hampton - Nurse Specialist/Manager Te Amo Health, Motueka (Te Kaunihera o Nga Neehi Māori – National Māori Nurses Organisation representative).

The Project Working Group met in June 2014 for an initial project definition and planning workshop, and began some of the review. The group were able to describe and agree the approach for the review and rewrite of the programme materials. A brief outline of key decisions includes: small groups to collaborate on the review of each learning package; those representing a particular palliative care setting then to have an overview of all the learning materials to ensure they are ‘fit for purpose’ for that setting; and some process detail around timing, method of review, and some contingency options.

Two research papers, looking at the delivery of the existing programme in 2012, will inform the review of the Fundamentals programme. Hospice NZ contracted Pukeko Research Ltd to undertake a summative evaluation of all nine learning packages in the Fundamentals programme, and Mercy Hospice Auckland partnered with the University of Auckland to evaluate a one site pilot.

The key recommendations from the Pukeko Research study are:
• The Fundamentals is a popular and successful programme, no changes to the programme are recommended here.
• That the evaluation sheet be rewritten into a simplified form including mainly quantitative and some qualitative material, tailored to the goals of each course, rather than continue in a generic format.
• The post-training audit form needs to be completely reconceived, as the responses given are unable to fit the form’s requirements for evidence of change.
• All materials need to be developed to be simple, clear, easily collected, comprehensive across institutions and clearly able to evaluate each course against its goals.

The results of the University of Auckland study found the Fundamentals was of benefit and relevance to participants, who felt the course was useful to them through increased knowledge and skills. Some refinements to the learning were recommended, including knowing participants prior experiences and learning potential, a more formal assessment process, creating a more diverse range of methods for building knowledge and skills, and improving methods of evaluation.

The research and evaluation to date, and the expertise and experience of the governance and working groups will support the review and development of the Fundamentals for all palliative care settings. However, an even wider range of input from professionals across all settings will help us ensure a quality education programme is delivered to the palliative care sector.

If you would like to discuss any of the education project information please contact the Hospice NZ CEO, Mary Schumacher via the contact us form

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