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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