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Evaluation of a toolkit resource package to support positive workplace behaviours in relation to quality end-of-life care in Australian hospitals
  1. Claire Hutchinson,
  2. Jennifer Tieman,
  3. Kim Devery
  1. Palliative and Supportive Services, Flinders University Faculty of Medicine, School of Health Sciences, Adelaide, South Australia, Australia
  1. Correspondence to Professor Jennifer Tieman; jennifer.tieman{at}


Background The study aimed to determine the effectiveness of an action-orientated toolkit in supporting behaviour change in relation to quality end-of-life care in acute hospital settings. The toolkit was developed to complement a programme of online end-of-life care education.

Methods A toolkit was developed from an international review of peer-reviewed literature on end of life. Toolkits were distributed (n=428) to Australian healthcare professionals over a 4-week period. An online survey was sent to all recipients; 65 responses were received (16% response rate, excluding emails returned as undeliverable). Semistructured interviews (n=10) were conducted using purposeful sampling to ensure a range of views were captured. The focus of the evaluation was on investigating (1) users’ responses to the toolkit and (2) individuals’ reported behaviour change.

Findings The toolkit was well received by users who reported increased confidence in communication around end-of-life matters. 59.3% of users reported making a behaviour change over the previous 4 weeks; 70.8% of those who had not made a change reported they intended to in the near future. Against expectation, the toolkit’s appeal went beyond its intended audience in acute hospital settings, for example, personal care workers in aged care settings.

Conclusions Despite study limitations (self-report of a small, self-selected sample), these early findings suggest that the toolkit has potential to positively impact on end-of-life care practices. However, additional evaluation is needed to determine whether such a toolkit can positively impact on practice and on patient experience at the end of life.

  • health services research
  • healthcare quality improvement
  • health professions education

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  • Contributors The toolkit and its evaluation was conceptualised by JT and KD. The toolkit was developed by CH with feedback from JT and KD, as well as a panel of medical experts. CH developed the evaluation materials, collected and analysed the data. Agreement on the themes and key messages was by consensus of all authors. The paper was drafted by CH. All authors commented, reviewed and approved the final draft.

  • Funding The End-of-Life Essentials Project is funded by the Australian Government Department of Health.

  • Competing interests CH and KD have received salary funding from the project.

  • Patient consent Not required.

  • Ethics approval Ethics approval for this project was provided by the Flinders University Social and Behaviour Ethics Committee (7568).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data access can be requested by contacting the corresponding author.

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