Project Echo

Connecting Palliative Care Across Ireland

Project ECHO AIIHPC: Nursing Homes

The first project ECHO AIIHPC training programme, funded by the HSE, was delivered to nursing homes within South Dublin and facilitated by the multidisciplinary palliative care team at Our Lady's Hospice & Care Services. The next phase, which commenced in February 2018, extended invitations out to the remaining homes within Dublin and is facilitated jointly by the multidisciplinary palliative care teams at St Francis Hospice and Our Lady's Hospice & Care Services.

The ECHO AIIHPC Nursing Home project is designed to support nursing home staff to improve their knowledge and skills in the care and management of patients with a wide range of palliative healthcare needs.

Phases one and two of the project brought together palliative care staff from St Francis Hospice and Our Lady’s Hospice & Care Services (the hub) and nursing home staff (the spokes). Phase three commenced in May 2019 in collaboration with Milford Care Centre, linking in with 15 nursing homes in the mid west of Ireland.

Each ECHO lasted one hour and thirty minutes, accessed from within each nursing home facility using teleconferencing software.  Through fortnightly teaching sessions and case presentations, nursing home staff had the opportunity to discuss patient scenarios which they have found challenging and determine the best course of future treatment. The network will foster a spirit of learning from each other in a safe environment.

The key aim of the Nursing Homes project is to build skills and knowledge of staff to improve their resident’s experiences and avoid unnecessary emergency department attendances or hospital stays.  A further objective is that nursing home staff teams will feel empowered to access relevant palliative care services appropriately and become an effective connected learning community.

Phase One Aims & Objectives were to:

  • Determine whether confidence levels were enhanced among the participating nursing homes  in managing the conditions specifically relating to the topic discussed
  • Determine whether enhanced confidence levels, if present, persisted for at least 6 weeks.

Results

  • 22 participating nursing homes participated
  • Staff confidence was enhanced by 40% post echo
  • Effect persisted for at least 6 weeks post echo
  • Effect was similar regardless of years experience, staff role

A full report on the evaluation of the first phase of Project ECHO AIIHPC: Nursing Homes can be viewed here and a peer reviewed paper has also been published in the Journal of Palliative Medicine view here

Phase 3 was delivered via Milford Care Centre and involved 13 nursing homes in the Midwest area. 

Phase 3, linked specialist palliative care staff at Milford Care Centre Limerick, with Nursing Homes in the Midwest.Fifteen nursing homes from the Midwest of Ireland commenced phase 3 an 13 Nursing Homes (n=366 staff) participated in the programme. An evaluation of phase 3 has been conducted by researchers in the University of Limerick and will be available in Spring 2020.  Phase Three aims & objectives were a combination of the aims of phases 1 & 2.

Project ECHO AIIHPC: OT & Physio (Phase 4)

The Project ECHO AIIHPC: OT & Physio programme was developed and delivered with the overall aim of improving access to palliative care for those in the community by offering easily accessible and up-to-date training on principles of palliative care and best practices to occupational therapists and physiotherapists who deliver primary care in communities throughout Ireland. The Hub consisted of occupational therapists, physiotherapists, a dietician and a nurse manager, and was led by Palliative Care National Clinical Therapy Leads and facilitated by an allied health professional with academic, research and clinical experience in palliative care delivery. The ECHO Spokes were occupational therapists and physiotherapists (n=26) who were working in primary care and attended remotely from their workplace. An evaluation of phase 4 has been conducted by researchers in the Trinity College Dublin and will be available in Spring 2020.

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