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In the lead up to the upcoming 6th Annual Emergency Department Management Conference, Dr Christine Drummond, Senior Palliative Care Consultant, Critical Care Services Project Officer at the Lyell McEwin Hospital, Northern Adelaide Local Health Network joined us to discuss her experiences working in ED, ICU, General Practice and palliative care services, and the importance of community partnerships in taking care of dying patients in ED.
After more than a decade working in a major Emergency Department in Adelaide and in general practice, and being trained as a specialist palliative care physician and a Consultant for 12 years, what are the highlights of your career?
Christine: The highlights of my career in more recent years have been the opportunities I have had to influence system change to more patient-centred models. An example of this was the development of a mental health assessment (including a drug and alcohol assessment) and support system for all patients referred to our palliative care service.
This was only possible through collaboration with our Medicare Local, which has a comprehensive mental health team. We were able to upskill and support our staff in mental health assessment through the use of a distress tool and the outcomes for the staff included greater confidence in recognising distress and more focussed efforts from early after referral, to deal appropriately with distress. It seemed that the taboo of asking about alcohol and drug use was also being broken.
You were the Acting Clinical Head of Lyell McEwin Palliative Care Service, one of the major palliative care services in Adelaide, for 5 years. What are some of your experiences and lessons learnt in that role?
Christine: Being in the role of Acting Head of the Lyell McEwin Palliative Care Service was an extremely rich experience. I learnt a lot about the value of a dedicated team, the need to encourage others to develop their leadership qualities and the need to genuinely understand the needs of the community we were serving in order to have a truly responsive service of excellent quality.
We took risks in service improvement initiatives and although we were often tired, we were very energised by our ability to achieve outcomes for our community through liaison with other teams, and taking a very broad approach to our role.
You are presenting at the conference on the topic “Going well….Care of the Dying in Lyell ED”. How important do you think community partnerships are in providing care for these patients?
Christine: Community partnerships have been extremely important in the development of our Dying in the ED (and ICU) Care Plans. We began with the philosophical perspective that grief is best supported by a community, which is where our ED now has connections, through the Medicare Local.
Our Regional Volunteer Association are assisting in the funding and maintenance of facilities in the Comfort Cupboard. The SA Palliative Care Council have assisted us to hold large staff education fora, which have included ED and ICU staff.
It has been interesting to see how ED and ICU staff are increasing their understanding of their Units’ connection with the community.
You are facilitating a post conference workshop alongside Reverend Jeff May, Ecumenical Coordinating Chaplain for Lyell McEwin Hospital, on “Developing a comprehensive model of care for the patient who dies in ED”. Can you briefly explain some of the outcomes you and Reverend May have experienced?
Christine: The major outcomes from our initiative so far are increased staff awareness and education around caring for dying patients, reduced anxiety in accepting that someone is dying, much better GP liaison after the death and bereavement care for the loved ones. The reduction in staff anxiety around the environment we provide is also very significant.