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Extension of Community Health Outcomes in palliative and end of life care training in nursing homes Emma Westerdale, Sister – Project ECHO
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What is ECHO?
• Started as a way to meet local healthcare needs.
• Created by Sanjeev Arora, M.D., a liver disease doctor in Albuquerque, New Mexico, US.
• Use technology to reach larger numbers of healthcare providers.
• Aimed to:
– Improve patient outcomes.
– Improve sharing of best practice.
– Build a community of practice.
• Training delivered through case-based learning.
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St Luke's Proposal • Funded by Health Education England.
• Hub based at Clifford House.
• Combination of ECHO technology and face-to-face mentoring by St Luke’s Community team.
• Model designed to optimise access to education and training for nursing home staff and care agency staff.
• Health Education Yorkshire and Humber End of Life care Learning Outcomes.
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St Luke’s ECHO Timeline
• September – January: Project Preparation
Recruitment of core ECHO team
Development of educational resources and assessment tools
Commence engagement with nursing home community
Establish framework for pilot duration
• February - June: Pilot in Practice Launch of pilot
20 week education programme/ collection and review of data
Review pilot impact
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Nursing Homes • Opened to all nursing homes across Sheffield.
Belmont House
Alpine Lodge
Alexander Court
Abbey Grange
Mickley Hall
Eagle House
Pexton Grange
Fulwood Lodge
• Representatives from each home should include as a minimum: 1 x Registered Nurse (RN) and 1 x Healthcare Assistant (HCA).
• Participating homes should have an interest in improving staff members’ knowledge, skills and confidence.
• St Luke’s will provide all necessary equipment and resources.
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‘Two Pronged’ Approach
Distance learning
• Use of case-based learning.
• ECHO model of telementoring
• Peer support
• Shared best practice
• Online community
• Accessible learning materials
In house support
• Opportunity to work face-to-face with a Specialist HCA in-house.
• Receive input from Project Lead/Community Specialist Palliative Care Nurse (CSPCN) with a clinical caseload.
• Practical workshops
• Mentoring in revalidation for RNs.
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Core principles of Project ECHO
• Equality and accessibility of education to all levels of healthcare professionals.
• Provision of a safe, non-judgemental environment for Spokes to share best practice, access peer support and acquire and enhance knowledge and skills.
• Promote understanding of the fundamental goals of palliative care.
• Provide a process of continuous learning; using a range of methods to disseminate knowledge.
• Provision of bespoke education - tailored to meet the identified needs.
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• Provision of a clear and definitive framework of support and identifiable contacts to access.
• Provide access and support to educational resources to enhance the learning experience.
• Gain an understanding of the value of reflective practice.
• Use - and prompt - effective leadership to drive improvements in existing practice.
• Enhance the peer support experience through establishment of an ECHO community and successful collaborative working.
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Success so far??
• 80-90% attendance to each live ECHO session
• Case presentations provide discussion
• Increase in referrals from participating homes
• AP in house support and documentation review
• 100% take up of Syringe Driver Training
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• Thought provoking’
• ‘It is good to hear other home's practice...each home is contributing towards a practice that promotes quality of life.’
• ‘Good use of technology to bring everyone together’
• ‘I think that this form of learning is really good, forward thinking and I believe this would be beneficial in other areas as well as EOL’
• ‘It was easily accessible, it was a very supportive way to look at end of life care and participants were helpful to each other. Great way to receive training’
• ‘I liked how we were all in a group on webcam. It made me feel as if I was more involved and included’
• ‘I have never taken part in a "live" video link learning exercise before, and I found it exciting and enjoyable, - although nerve wracking, the facilitators really made me and my colleagues feel at ease!’
• ‘Nice to know we are not on our own’
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Any Questions?
Thank you
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